The treatment of congenital pseudarthrosis of the tibia with ipsilateral fibular transfer to make a one-bone lower leg: a review of the literature and case report with a 23-year follow-up.

Abstract

The surgical making of a one-bone lower leg is, in a way, an operation of necessity or last resort. It has been attempted for many conditions and by many techniques. This is a review of the literature and a case report of transferring a congenitally pseudarthritic fibula to replace an ipsilateral pseudarthritic tibial diaphysis without exposing the fibular vascular pedicle, or using microvascular techniques, and with the specific aim of purposely creating a true one-bone lower leg, the tibula. The concept and surgical technique used here leave the contralateral leg undisturbed and are less demanding, time consuming, and costly than a vascularized pedicle graft or bone transport. This procedure is new and can also be applied when the fibula is normal and to repair tibial diaphyseal deficiency from any cause in both children and adults.