Stéphanie Pannier1, Zagorka Pejin1, Caroline Dana1, Alain Charles Masquelet2, Christophe Glorion1. 1. Department of Pediatric Orthopedics, Université Paris Descartes, Sorbonne Paris Cité, Hôpital Necker Enfants Malades, 149 rue de Sèvres, 75015 Paris, France. 2. Department of Orthopedic Surgery, Université Paris XIII, Hôpital Avicenne, Bobigny, France.
Abstract
PURPOSE: The purpose of this study was to evaluate the two-stage surgical technique combining induced membrane, spongy autograft and intramedullary fixation for the treatment of congenital pseudarthrosis of the tibia (CPT). METHODS: Three boys and two girls were treated by this technique between 2003 and 2008. All patients had type IV CPT in Crawford's classification. Four of them had a limited dystrophic form, whereas one case presented an extensive tibia bone dystrophy. The average age of patients at the time of surgery was 23 months (range 10-30 months), with an average follow-up of 5.8 years (range 2.4-8.1 years). RESULTS: Satisfactory tibial bony union was achieved in all cases at the last follow-up. Bone healing was obtained in the four limited forms after an average term of 4 months. One patient suffered from a non-displaced fracture that healed by casting in a usual period of time. The patient with an extensive dystrophic bone had to undergo a secondary inter-tibiofibular bone graft to finally achieve bone union. CONCLUSIONS: The preliminary results show that this technique is successful in CPT. It may be used even in young children and offers a good alternative to other treatments available, avoiding external fixation and the technical difficulties of microvascular surgery.
PURPOSE: The purpose of this study was to evaluate the two-stage surgical technique combining induced membrane, spongy autograft and intramedullary fixation for the treatment of congenital pseudarthrosis of the tibia (CPT). METHODS: Three boys and two girls were treated by this technique between 2003 and 2008. All patients had type IV CPT in Crawford's classification. Four of them had a limited dystrophic form, whereas one case presented an extensive tibia bone dystrophy. The average age of patients at the time of surgery was 23 months (range 10-30 months), with an average follow-up of 5.8 years (range 2.4-8.1 years). RESULTS: Satisfactory tibial bony union was achieved in all cases at the last follow-up. Bone healing was obtained in the four limited forms after an average term of 4 months. One patient suffered from a non-displaced fracture that healed by casting in a usual period of time. The patient with an extensive dystrophic bone had to undergo a secondary inter-tibiofibular bone graft to finally achieve bone union. CONCLUSIONS: The preliminary results show that this technique is successful in CPT. It may be used even in young children and offers a good alternative to other treatments available, avoiding external fixation and the technical difficulties of microvascular surgery.
Entities:
Keywords:
Congenital pseudarthrosis of the tibia; Induced membrane
Authors: F Grill; G Bollini; P Dungl; J Fixsen; F Hefti; E Ippolito; B Romanus; C Tudisco; S Wientroub Journal: J Pediatr Orthop B Date: 2000-04 Impact factor: 1.041