Use of the Fassier-Duval telescopic rod for the management of congenital pseudarthrosis of the tibia

Abstract

Introduction: Congenital pseudarthrosis of the tibia (CPT) is a rare condition that can pose a challenge in achieving union after surgical excision of the pseudarthrosis site. Multiple methods have been described for management of fractures complicating this abnormal bone, including intramedullary nails (IMNs) and external fixators. One of the IMN designs is the telescoping nail, which has many models including the Fassier-Duval (FD) rod. This system has been known for its use in the management of osteogenesis imperfecta and different types of dysplasia. In this series, we describe our experience with the use of this system in the management of CPT of the tibia in children. Methods: We conducted a retrospective chart review of four patients with FD rod insertions for CPT management. The mean age at surgery was 7.6 years (range: 1.5-17) and the minimum follow-up was 20 months (average: 52.3 months, range: 20-93 months). Two out of the four patients had a concomitant diagnosis of neurofibromatosis Type 1. Results: All four cases achieved union of the fracture at final follow-up. Complications encountered in these cases included a case of joint intrusion into the knee and a case of rod migration due to the failure of telescoping. Conclusion: The FD rod showed promising results in our cohort, but before this treatment modality can be recommended for the management of CPT, additional studies are required. Level of Evidence: IV