Mohammed Anter Meselhy1, Adel Samy Elhammady2, Mohamed Salah Singer2. 1. Orthopedic Department, Benha University, Kafer el gazar, Benha, 13511 Qalyubia, Egypt. Electronic address: m.anteroof@yahoo.com. 2. Orthopedic Department, Benha University, Kafer el gazar, Benha, 13511 Qalyubia, Egypt.
Abstract
BACKGROUND: Although a remarkable success in the treatment of congenital pseudarthrosis tibia (CPT) had been achieved, failure rate is still high and the likelihood of amputation is still considerable. The current study evaluates the outcome of induced membrane technique in the treatment of failed previously operated patients of congenital pseudarthrosis of the tibia. We hypothesized that induced membrane technique will improve union rates in CPT with failed previous multiple operations. PATIENTS AND METHODS: Nineteen consecutive patients of failed previously operated CPT were prospectively included in the study. All patients were treated by induced membrane technique with autogenous free non-vascularized fibular strut graft augmented by autogenous iliac graft and fixed by intramedullary K-Wire as well as Ilizarov external fixator. RESULTS: The mean interval between the 1st and 2nd stages of the procedure was 4.9 weeks. Sound union was achieved in all cases in a mean time of 25.3 weeks. The mean follow up period was 5.02 years (range, 2.4-6.5). No refracture was documented till last follow up. CONCLUSION: Induced membrane technique had proved as a successful method in the treatment of failed previously operated CPT with a satisfactory outcome and low complication rates. LEVEL OF EVIDENCE: IV.
BACKGROUND: Although a remarkable success in the treatment of congenital pseudarthrosis tibia (CPT) had been achieved, failure rate is still high and the likelihood of amputation is still considerable. The current study evaluates the outcome of induced membrane technique in the treatment of failed previously operated patients of congenital pseudarthrosis of the tibia. We hypothesized that induced membrane technique will improve union rates in CPT with failed previous multiple operations. PATIENTS AND METHODS: Nineteen consecutive patients of failed previously operated CPT were prospectively included in the study. All patients were treated by induced membrane technique with autogenous free non-vascularized fibular strut graft augmented by autogenous iliac graft and fixed by intramedullary K-Wire as well as Ilizarov external fixator. RESULTS: The mean interval between the 1st and 2nd stages of the procedure was 4.9 weeks. Sound union was achieved in all cases in a mean time of 25.3 weeks. The mean follow up period was 5.02 years (range, 2.4-6.5). No refracture was documented till last follow up. CONCLUSION: Induced membrane technique had proved as a successful method in the treatment of failed previously operated CPT with a satisfactory outcome and low complication rates. LEVEL OF EVIDENCE: IV.