Congenital Pseudarthrosis Tibia

1
Congenital Pseudarthrosis Tibia
1Hatem Kotb, MD 2Gamal Hosny, MD 3Mohamed
Fadel, MD Department of Orthopedic Surgery,
1El-Faywom Faculty of Medicine, 2Benha Faculty
of Medicine, 3El-Minia Faculty of Medicine, Egypt
fadelminia_at_yahoo.com
Congenital pseudarthrosis of the tibia is one of
the most challenging paediatric orthopaedic
problems to treat. The problem of marked
deformity, osteoporosis, scars from previous
operations and shortening may limit the outcome
of surgical treatment. We report a single author
experience with the use of Ilizarov method in
treating 15 cases of CPT
Material Methods From 1992-2002, 17 cases were
treated in our center.2 cases were excluded. Age
of patients at operation ranged from 9 months to
16.5 years with an average of 9 years. 12
patients had previous surgery with a range from
2-13 operations. There were 10 females. The left
side was treated in 9 cases. Neurofibromatosis
was evident in 7 cases. The site of the disease
was the distal tibia in all cases. Leg length
discrepancy ranged from 2-17 cm average 7 cm.
One case had deep infection due to previous
surgery. Evaluation parameters were union, pain,
functional activity, axis deviation, leg length
inequality, satisfaction of the patient.
Results After an average follow up 6.5 years
range 2.5-10 years, there were 7 good, 4 fair
and 4 poor results. Union was achieved initially
in all cases except 2.
Complications included 1-Pin tract infection in
all cases. 2-Refracture in 5 cases. 3-Premature
consolidation of the area of lengthening in 2
cases. 4-Fractureof the regenerate in 1 case.
Conclusion Ilizarov method has an important role
in treatment of CPT. However the problem of
refracture has not been solved yet. The follow up
beyond skeletal maturity may be needed.