先天性下腿偽関節症の治療経験

Abstract

We report a case of congenital pseudarthrosis of the tibia. A 1-year 2-month old boy was admitted to our hospital with congenital pseudarthrosis of the tibia. He presented right leg deformity with anterolateral bowing. His mother and grandmother were given a diagnosis of neurofibromatosis 1, and he himself had numerous cafe-au-lait spots.He was treated by excision of the pseudarthrosis and segmental bone transport at 1 year 8 months old, but could not achieve union at the distal docking site. He then underwent autogenous-iliac bonegraft at 2 years 8 months old, but could not obtain union at the distal tibia.When he was 4 years 9 months old, he underwent grafting of the ipsilateral fibula to the tibia as described by Goldberg et al. in 1988. After the operation, due to valgus deformity after fracturing the transplanted fibula, an intramedullary rod was inserted.Solid union and hypertrophy of the graft was achieved at 6 years old. Residual deformities include tibial angulation and leg length discrepancy, but he has been able to walk with a long leg brace without any complaints.