Free Vascular Fibular Transfer in Congenital Pseudoarthrosis of the Tibia: Results of the EPOS Multicenter Study

Romanus, B.; Bollini, G.; Dungl, P; Fixsen, J. A.; Grill, Franz; Hefti, Fritz; Ippolito, Ernesto; Tudisco, Cosimo; Wientroub, Shlomo

doi:10.1097/01202412-200004000-00003

Cited by 62 publications

(39 citation statements)

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“…Several series of surgical outcomes have been reported [von Satzger and Herbst, 1981;Murray and Lovell, 1982;Anderson et al, 1992;Coleman and Coleman, 1994;Gilbert and Brockman, 1995;Traub et al, 1999;Grill et al, 2000;Romanus et al, 2000;Tudisco et al, 2000;Wientroub and Grill, 2000;Dobbs et al, 2004; Ohnishi et al, 2005;Bara et al, 2007]; however, the number of patients is usually small and there is no consensus regarding the treatment for pseudarthrosis. Comparison of studies is difficult because of limited follow up, age differences, lack of designation of NF1, severity of the dysplasia, number of surgeries, and use of ancillary treatments.…”

Section: Dysplasia Of the Tibia And Other Long Bonesmentioning

confidence: 99%

Skeletal abnormalities in neurofibromatosis type 1: Approaches to therapeutic options

Elefteriou

Kolanczyk

Schindeler

et al. 2009

American J of Med Genetics Pt A

131

112

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The skeleton is frequently affected in individuals with neurofibromatosis type 1, and some of these bone manifestations can result in significant morbidity. The natural history and pathogenesis of the skeletal abnormalities of this disorder are poorly understood and consequently therapeutic options for these manifestations are currently limited. The Children's Tumor Foundation convened an International Neurofibromatosis Type 1 Bone Abnormalities Consortium to address future directions for clinical trials in skeletal abnormalities associated with this disorder. This report reviews the clinical skeletal manifestations and available preclinical mouse models and summarizes key issues that present barriers to optimal clinical management of skeletal abnormalities in neurofibromatosis type 1. These concepts should help advance optimal clinical management of the skeletal abnormalities in this disease and address major difficulties encountered for the design of clinical trials. © 2009 Wiley‐Liss, Inc.

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Section: Dysplasia Of the Tibia And Other Long Bonesmentioning

confidence: 99%

Skeletal abnormalities in neurofibromatosis type 1: Approaches to therapeutic options

Elefteriou

Kolanczyk

Schindeler

et al. 2009

American J of Med Genetics Pt A

131

112

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“…Other methods include direct current or pulsed electromagnetic field [34,35], ipsilateral transfer of the fibula [31] or contralateral free vascularized fibular transfer [12,13,15,16,24,36,39,41], circular external fixation [14,16,33,39,40], IM rodding [7,10,11,21,23,26], and combined external fixation and IM rodding [14,16,33]. Recently, bone morphogenetic protein (BMP) [27,37] and Table 1.…”

Section: Introductionmentioning

confidence: 99%

Periosteal Grafting for Congenital Pseudarthrosis of the Tibia: A Preliminary Report

Thabet

Paley

Kocaoğlu

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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The results of treatment of congenital pseudarthrosis of the tibia (CPT) are frequently unsatisfactory because of the need for multiple operations for recalcitrant nonunion, residual deformities, and limb-length discrepancies (LLD). Although the etiology of CPT is basically unknown, recent reports suggest the periosteum is the primary site for the pathologic processes in CPT. We hypothesized complete excision of the diseased periosteum and the application of a combined approach including free periosteal grafting, bone grafting, and intramedullary (IM) nailing of both the tibia and fibula combined with Ilizarov fixation would improve union rates and reduce refracture rates. We retrospectively reviewed 20 patients at two centers. The minimum followup was 2 years (mean, 4.3 years; range, 2-10

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“…However, in most of the cases, numerous operations were needed, either because of frequent non-unions either or repeated fractures in a short delay. Nowadays, the most commonly used techniques applied either individually or in combination are nailing, vascularized bone graft, and Ilizarov-type circular external frame [20,22,23,[25][26][27][28][29][35][36][37][38][39][40][41][42].…”

Section: Discussionmentioning

confidence: 99%

“…Numerous procedures have been described in this treatment, with varying degrees of success [19][20][21][22][23][24][25][26][27][28][29]. Moreover, the knowledge of the phenomena altering the physiological bone tissue or the periosteum in neurofibromatosis type 1 (NF1) is not yet complete and has improved even more recently.…”

Section: Introductionmentioning

confidence: 99%

Masquelet's procedure and bone morphogenetic protein in congenital pseudarthrosis of the tibia in children: A case series and meta-analysis

Dohin

Köhler²

2012

Journal of Children's Orthopaedics

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Purpose A type 2 recombinant human bone morphogenetic protein (rhBMP2) and Masquelet's procedure were used in three children presenting with congenital pseudarthrosis of the tibia (CPT). Recent studies on CPT suggested the presence in situ of pathologic tissues promoting pseudarthrosis. The authors hypothesized that large segmental resection of pseudarthrosis could improve prognosis of the CPT. Masquelet's procedure and rhBMP2 have been advocated for the treatment of long bone defect. Method The authors report three cases of CPT in children treated with Masquelet's procedure and application of rhBMP2. They analyzed all published cases of CPT similarly treated. Results In the present study, Masquelet's procedure did not improve the results in the treatment of CPT, but segmental bone reconstruction was possible. Bone healing was obtained in three out of the five applications of rhBMP2. In one case, the patient's parents asked for leg amputation. Analysis of the 33 published cases with the application of BMP in CPT points to a 62 % healing rate in this pathology. Conclusion The authors confirmed that segmental bone reconstruction is possible in CPT using Masquelet's procedure. In the literature, the success rate of the application of rhBMP in CPT appears to be lower than the healing rate usually reported without BMP. Nevertheless, the strict selection of patients, limited number of cases, and their heterogeneity make interpreting the results difficult. However, the theoretical risk which the children are exposed to during the use of BMP makes rigorous selection of the indications necessary. Finally, the interest of rhBMP2 application in Masquelet's procedure remained to be proven.

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Free Vascular Fibular Transfer in Congenital Pseudoarthrosis of the Tibia: Results of the EPOS Multicenter Study

Cited by 62 publications

References 0 publications

Skeletal abnormalities in neurofibromatosis type 1: Approaches to therapeutic options

Skeletal abnormalities in neurofibromatosis type 1: Approaches to therapeutic options

Periosteal Grafting for Congenital Pseudarthrosis of the Tibia: A Preliminary Report

Masquelet's procedure and bone morphogenetic protein in congenital pseudarthrosis of the tibia in children: A case series and meta-analysis

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