Abstract
Introduction: Congenital pseudoarthrosis is one of the greatest challenges of pediatric orthopedic practice. Treatment measures and literature addressing this condition are numerous reflecting the difficulty in management. The aim of successful treatment is to achieve length, union and normal axis of the involved leg.
A method of treatment is described whereby the affected tibia is united and lengthened.
Material and methods: Ten patients between six and thirty years of age were treated.
All patients suffered from Boyd 1 or 2 Psuedoarthrosis of the Tibia. All patients had had previous surgery (three to thirteen operations) and three to ten centimeter of shortening. All patients were treated by lengthening of the tibia and open debridement and compression of the pseudoarthrosis till union using Ilizarov techniques.
Results: All patients had eventual successful outcome.
Eight patients achieved union length and normalization of the tibial axis with the first operation and two patients had recurrence of the pseudoarthrosis and had re-operation with success.
Conclusion: Successful surgical treatment of pseudoarthrosis of the tibia is possible.
To achieve this success a number of basic principles need to be followed.
These principles are:
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Correction of the axis of the limb.
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Debridement of the pseudoarthrosis and opening of the intra medullary canal with insertion of one of the ends of the tibia into the other.
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Lengthening of the tibia with proximal osteotomy and concurrent compression of the fracture site.
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Absolute correction of the tibial axis.
This treatment regime has shown success in the failed management of the pseudoarthrosis and if these principles are adhered to this regime will have success in the management of this pathology and prevent re-operation.
The abstracts were prepared by Orah Naor. Correspondence should be addressed to him at the Israel Orthopaedic Association, PO Box 7845, Haifa 31074, Israel.
