Long-term follow-up on the use of vascularized fibular graft for the treatment of congenital pseudarthrosis of the tibia.

Abstract

Congenital pseudoarthrosis of the tibia (CPT) is one of the most difficult conditions to treat. Five girls and 3 boys with CPT were treated by vascularized fibular grafting (VFG). The average age at VFG was 7.0 years (range: 1.9-11.5 years) with an average follow-up term of 11.7 years (range: 4.9-19.6 years). Five of the children had undergone multiple operations before VFG, while the other 3 had no such history. Bone consolidation was obtained in all cases after an average term of 6.6 months (range: 4-10 months); this was with the first VFG in 7 cases but with the second VFG in 1 case. Complication of stress fracture and ankle pain occurred in 1 and 3 cases, respectively, only in cases undergoing multiple operations. Leg-length discrepancy was more prominent in the patients with multiple previous operations (mean: 7.5 cm), than in the cases with no prior surgery (mean: 0.7 cm). The long-term results of VFG for CPT were excellent, especially in the cases, with no prior surgery. VFG should be considered as a primary treatment option for CPT.