Congenital pseudarthrosis of both forearm bones: Long-term results of two cases managed by free vascularized fibular graft

Allieu, Y.; Reckendorf, G. Meyer Zu; Chammas, Michel; Gomis, R.

doi:10.1053/jhsu.1999.0604

Cited by 26 publications

(26 citation statements)

References 9 publications

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“…3 This method was most successful when the option of a 1-bone forearm was chosen. 19,23 In 1981, Allieu et al 24,47 reported the treatment of a 4-year-old patient with neurofibromatosis and congenital pseudarthrosis of both forearm bones. After an unsuccessful attempt using internal fixation with plates, union of both forearm bones was accomplished by FVFG for the radius at first and for the ulna a year later.…”

Section: Discussionmentioning

confidence: 99%

“…In most of the cases, besides bony union, forearm function was adequate as well. 15,47 Complications after FVFG include nonunion in 1 patient, 15 refracture in 2 patients, 14,15 angular deformity at the distal graft site in 1 patient, 11 and poor pronationsupination in 2 patients. 14,15 Predisposing factors include inadequate graft fixation, proximity of the pseudarthrosis to an epiphysis, and the age of treatment.…”

Section: Discussionmentioning

confidence: 99%

“…14,15 Predisposing factors include inadequate graft fixation, proximity of the pseudarthrosis to an epiphysis, and the age of treatment. 11,14,47 In previous cases of FVFG for the radius alone, 1 case of dorsal subluxation of the distal radial fragment has been described. 11 This complication was noticed 3 weeks postoperatively and required open reduction of the radial fragment and stabilization with a K-wire 6 weeks after surgery.…”

Section: Discussionmentioning

confidence: 99%

“…It is therefore important to treat the pseudarthrosis as early as possible to avoid progressive deformities of the forearm and wrist. 14,15,47 The location of the pseudarthrosis may also influence the outcome. A pseudarthrosis close to the distal epiphyseal plate renders adequate bone and soft tissue excision difficult.…”

Section: Discussionmentioning

confidence: 99%

“…Fibular graft fixation with K-wires or an intramedullary pin may be inadequate, leading to angular deformity of the distal radial fragment. 11,47 Graft fixation with plates may offer a better alternative and lead to quicker union even if damage to periosteal blood supply will occur to some extent. In our case, proximal graft end fixation was achieved by a small semitubular plate, whereas stabilization of the distal one was performed using a K-wire, to avoid damaging the growth plate of the distal radius, in addition to an external fixator.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Congenital Pseudarthrosis of the Radius Treated With Gradual Distraction and Free Vascularized Fibular Graft: Case Report

Beris¹,

Lykissas²,

Kostas-Agnantis³

et al. 2010

The Journal of Hand Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Congenital Pseudarthrosis of the Radius Treated With Gradual Distraction and Free Vascularized Fibular Graft: Case Report

Beris¹,

Lykissas²,

Kostas-Agnantis³

et al. 2010

The Journal of Hand Surgery

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Reconstruction of congenital pseudarthrosis of the radius with a vascularized tibial periosteal transplant: A case report

da Costa,

Farina Brunelli,

Rojas‐Neira

et al. 2024

Microsurgery

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Congenital pseudarthrosis of the forearm poses a considerable challenge because of its rarity. The objective of this report is to introduce a novel surgical technique for its treatment. Here, we document a case of congenital pseudarthrosis of the radius in a 3‐year‐old boy diagnosed with type‐1 neurofibromatosis. The surgical treatment involved the excision of approximately 9 cm of native radial periosteum and a bifocal radius osteotomy, which was supplemented with a vascularized tibial periosteal transplant to facilitate bone healing. Anastomosis between the anterior tibial vessels and radial vessels was performed. No immediate or late postoperative complications were observed. After 3 weeks, a robust callus formation was observed, and during a follow‐up examination 3 years and 4 months later, a wide range of active forearm rotation was noted. This report suggests that vascularized periosteal flaps show promise as a viable treatment option for congenital pseudarthrosis of the forearm. They offer an alternative to vascularized fibular grafts or single‐bone forearm constructs.

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Congenital pseudarthrosis of radius. A case report

Mukhopadhaya¹,

Shivapuri²

2006

Strategies in Trauma and Limb Reconstruction

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We report a case of a 9 year old female child with congenital pseudarthrosis of the radius. She had a history of fractures of both bones of the left forearm after trivial trauma at the age of 7 years (2003) and 8 years (2004). On each occasion she was treated conservatively in a POP cast 4 weeks. She reported to us in January 2005 complaining of a gradually increasing deformity of the left forearm. Radiologically, it was an apex anterior deformity of the distal aspect of the left radius. Clinically she had multiple café au lait spots over her body. Neurological and ophthalmological examinations were normal. The fibrous tissue and the fracture ends were excised. The fracture was stabilized with a 6-hole DCP with iliac crest graft to bridge the gap along with cortico-cancellous chips. The fracture united uneventfully at 3 months post-operatively. At 17 months post-operatively there is no evidence of recurrence of pseudarthrosis with a near normal range of movements. Congenital pseudarthrosis of the radius is an extremely rare condition with only 10 cases seems to have been reported. Dual onlay bone graft, vascularised fibular graft has been the treatment options the latter being the preferred one. But the disease being extremely rare not much has been documented about the treatment options. We treated this case by excision of the sclerotic bone ends along with a cuff of periosteum and internal fixation with DCP along with iliac strut graft to restore the length. Successful union was achieved in 3 months and the patient has satisfactory follow-up at 17 months.

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Congenital pseudarthrosis of both forearm bones: Long-term results of two cases managed by free vascularized fibular graft

Cited by 26 publications

References 9 publications

Congenital Pseudarthrosis of the Radius Treated With Gradual Distraction and Free Vascularized Fibular Graft: Case Report

Congenital Pseudarthrosis of the Radius Treated With Gradual Distraction and Free Vascularized Fibular Graft: Case Report

Reconstruction of congenital pseudarthrosis of the radius with a vascularized tibial periosteal transplant: A case report

Congenital pseudarthrosis of radius. A case report

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