Relationship between postoperative complications and operative age for congenital pseudarthrosis of the tibia in children

Abstract

Objective To explore the relationship of postoperative complications and operative age for congenital pseudarthrosis of the tibia (CPT) in children. Methods A retrospective study was conducted on the relationship of postoperative complications and operative age for CPT in children.Between December 2007 to October 2011, 59 patients with Crawford type Ⅳ CPT undergoing combined operative procedures were analyzed.They were divided into 2 groups, i.e.CPT aged 3 years (group B) according to operative age.We compared the incidence of re-fracture, ankle valgus, proximal tibial valgus and limb length discrepancy of two groups. Results In group A, 31/34 (91.2%) patients achieved primary union, 7(22.6%) cases had re-fracture, 14(45.2%) cases of ankle valgus had an average ankle valgus of 11.3 (5 -25 ), 13(41.9%) cases of proximal tibial valgus had an average proximal tibial valgus of 8.5 (5 -20 ) and 14 (45.2%) cases had limb length discrepancy with an average limb length of 2.4 (0.5 -4.0) cm.In group B, 21/25(84.0%) patients achieved primary union, 7(33.3%) cases had re-fracture, 8 (38.1%) cases of ankle valgus had an average ankle valgus of 13.8 (5 -30 ), 12(57.1%) cases of proximal tibial valgus had an average proximal tibial valgus of 9.5 (5 -20 ) and 16 (76.2%) cases of limb length discrepancy had an average limb length of 1.8 (1-3) cm.Significant inter-group differences existed in limb length discrepancy (P=0.044). Conclusions For CPT patients aged above 1 year without no severe osteoporosis and decent nutritional status, surgery should be preformed to reduce the incidence of postoperative complications of limb length discrepancy. Key words: Congenital pseudarthrosis of the tibia; Postoperative complications; Sequel deformity