Congenital pseudarthrosis of the tibia: Results of circular external fixation treatment with intramedullary rodding and periosteal grafting technique

Kocaoğlu, Mehmet; Eralp, Levent; Bilen, F. Erkal; Cıvan, Melih

doi:10.5152/j.aott.2020.03.26

Cited by 10 publications

(10 citation statements)

References 31 publications

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“…Among them, ankle deformity was revealed by anteroposterior weight-bearing radiographs in 4 patients (case 1, 2, 6 and 11). The rate of residual deformity was similar to or better than that reported in earlier series (15,24,25). Other complications include refracture and pin tract infection (Table 2).…”

Section: Resultssupporting

confidence: 84%

“…The combination of IM rodding, circular external xation and iliac bone grafting have been generally accepted as an effective procedure in protecting against refracture, promoting alignment control with high fusion rate and contributing to early removal of external xator (7,9,11,25,32). Since 2013, we applied prebent TENs instead of using conventional IM rod for internal xation.…”

Section: Im Xation Was the Primary Choice In Union Achievement And Prmentioning

confidence: 99%

“…Refracture occurred in only 2 ( (9). In a recent study using combined techniques of hamartoma resection, periosteal grafting, circular external xator application, and intramedullary rodding, 5 (29.4%) of 17 CPT cases were complicated by refractures (10). As additional refractures may occur before patients reach skeletal, nal outcomes should be assessed after all the patients have reached this milestone.…”

Section: Im Xation Was the Primary Choice In Union Achievement And Prmentioning

confidence: 99%

“…Currently, the combined treatment including resection of the pseudarthrosis and surrounding hamartomatous tissue, autogenous bone grafting and internal and external xation is the most commonly used techniques (7,(9)(10)(11). Rigid xation is a crucial factor in the treatment of CPT.…”

mentioning

confidence: 99%

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Prebent Titanium Elastic Nailing, Ilizarov Fixation and Bone Grafting for Treating Congenital Pseudarthrosis of the Tibia: Preliminary Outcomes of 15 Cases

Wang

Zhang

et al. 2020

Preprint

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Background: To report the preliminary outcome of treating congenital pseudarthrosis of the tibia (CPT) by using titanium elastic nails (TENs) combined with other surgical procedures including pseudarthrosis resection, autogenous iliac bone grafting and Ilizarov technique, with a mean follow-up time of 4.5 (3.3 to 6.3) years.Methods: 15 patients with CPT treated by combined surgery including pseudarthrosis resection, titanium elastic nails (TENs) technique, autogenous iliac bone grafting and Ilizarov fixation between 2013 and 2017 were retrospectively investigated. Signs of bone union, limb length discrepancy (LLD), rate of refracture and degree of residual deformities were reviewed. The AOFAS Ankle Hindfoot scale and measurement of ankle movement were used to evaluate ankle function. Results: The mean age at index surgery was 110 (24 to 285) months. 13 (86.7 %) patients obtained union of the pseudarthrosis on the first attempt (primary union). The average time to primary union was 4.8 (3 to 7) months. The rest 2 cases achieved union after additional surgeries (secondary union). In terms of complications, refracture occurred in 2 patients (13.3%) and 5 (33.3%) patients developed pin infection. The mean limb length discrepancy at the final follow up was 14.6 (4–41) mm. 3 patients (20 %) had ankle valgus deformities with a mean LDTA of 74.3° (range, 68 to 81°). The average AOFAS score improved from 40.3 (27 to 51) pre-operatively to 76.1 (63 to 87) post-operatively. For the patients who received proximal tibial lengthening, the average healing index (HI) was 65.1 (57.3 to 77.8) days/cm.Conclusions: Titanium elastic nails (TENs) technique is an ideal intramedullary fixation method in the surgical treatment of CPT. The combination of TENs technique with bone grafting and Ilizarov fixation has the advantages of early bone union, less injury on metaphyseal and early functional recovery.

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Section: Resultssupporting

confidence: 84%

Section: Im Xation Was the Primary Choice In Union Achievement And Prmentioning

confidence: 99%

Section: Im Xation Was the Primary Choice In Union Achievement And Prmentioning

confidence: 99%

mentioning

confidence: 99%

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Prebent Titanium Elastic Nailing, Ilizarov Fixation and Bone Grafting for Treating Congenital Pseudarthrosis of the Tibia: Preliminary Outcomes of 15 Cases

Wang

Zhang

et al. 2020

Preprint

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“…Healing over the compression, with correction of LLD has been reported. The use of proliferative factors from stem cells are collaborative to achieve union [39][40][41][42][43].…”

Section: Osseous Involvement Of Long Bones 31 Tibiamentioning

confidence: 99%

Bone Lesions in Children with Neurofibromatosis

Laliotis¹

2022

Clinical and Basic Aspects of Neurofibromatosis Type 1

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Neurofibromatosis is often related with severe orthopaedic disorders in children. Bone lesions are rare but pose severe difficulties in management. It affects the spine and long bones. Lesions are associated either from enlargement of neurofibromas that affect the normal growth or from primary neurofibromatosis of long bones. Dystrophic scoliosis appears with short curves, with kyphosis and rotation of the apical vertebrae. Usually affect the thoracic spine, with penciling of the ribs. Surgical treatment is challenging in cases of rapid progression. Scoliosis may appear with curvatures similar to those in idiopathic scoliosis, without dysplastic changes of the vertebrae. Anterior bowing of the tibia is manifestation of NF and is distinguished from the benign posterolateral bowing. Evaluation of the medullary canal and presence of cystic lesions in the tibia is essential. Progression to pseudoarthrosis or pathologic fracture is common. Surgical management of tibial pseudoarthrosis remains a difficult procedure. Pseudoarthrosis may appear in fibula, radius or ulna but are extremely rare. Irregular eccentric bone cysts in long bones that are commonly diagnosed after a pathologic fracture, must be differentiated for NF. Malignant transformation of neurofibromas must be considered when there is rapid progression of the lesion.

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Anterolateral Tibial Bowing and Congenital Pseudoarthrosis of the Tibia: Current Concept Review and Future Directions

Siebert

Makarewich

2022

Curr Rev Musculoskelet Med

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Congenital pseudarthrosis of the tibia: Results of circular external fixation treatment with intramedullary rodding and periosteal grafting technique

Abstract: The role of the platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in the prediction of length and cost of hospital stay in patients with infected diabetic foot ulcers: A retrospective comparative study

Cited by 10 publications

References 31 publications

Prebent Titanium Elastic Nailing, Ilizarov Fixation and Bone Grafting for Treating Congenital Pseudarthrosis of the Tibia: Preliminary Outcomes of 15 Cases

Prebent Titanium Elastic Nailing, Ilizarov Fixation and Bone Grafting for Treating Congenital Pseudarthrosis of the Tibia: Preliminary Outcomes of 15 Cases

Bone Lesions in Children with Neurofibromatosis

Anterolateral Tibial Bowing and Congenital Pseudoarthrosis of the Tibia: Current Concept Review and Future Directions

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