Isolated congenital pseudarthrosis of the fibula: A report of two cases and review of the literature

Cherrad, Taoufik; Zejjari, H.; Bousbaä, Hicham; Louaste, J.; Rachid, K.; Amhajji, Larbi

doi:10.1016/j.jcot.2018.07.004

Cited by 2 publications

(7 citation statements)

References 11 publications

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“…Isolated CPF is usually considered a less severe condition than CPT. However, its site–most frequently near the ankle–leads to severe valgus and instability of this weight-bearing joint ( 25 – 29 ). In Liu’s study ( 10 ), patients with fibular pseudarthrosis had a high incidence of refracture and ankle valgus, and he suggested that attention should be paid to the presence of fibular pseudarthrosis when managing CPT.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological and clinical characteristics of congenital pseudarthrosis of the tibia in China

et al. 2022

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BackgroundCongenital pseudarthrosis of the tibia (CPT) is a refractory and rare disease. Because of its extremely low incidence, little is known about its clinical features. In this retrospective study, we aim to analyze the clinical characteristics of patients with CPT.Materials and methodsThis is a retrospective study of children with CPT identified by the radiological review. Investigations of CPT included general conditions, the characteristics of CPT, treatment methods, and surgical complications.ResultsWe collected 514 CPT cases from March 1999 to March 2020 in our hospital, such as 317 (61.67%) boys, 197 (38.33%) girls; 330 (62.86%) in Crawford IV; 510 (97.14%) in mid and distal 1/3 tibia; 481 (93.58%) in less than 3 years at onset age; 297 (57.78%) in less than 3 years at the first outpatient visit. The most common post-operative complication was ankle valgus (101, 39.60%), followed by limb length discrepancy (91, 35.69%), refracture (38, 14.90%), osteomyelitis (15, 5.88%), and removal of internal fixation (10, 3.93%).ConclusionsCPT with a higher incidence of Crawford IV frequently occurs in boys and the middle or distal part of the tibia; most patients have the onset age and first outpatient visit before 3 years; the major surgical complications are ankle valgus and limb length discrepancy.

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Section: Discussionmentioning

confidence: 99%

Epidemiological and clinical characteristics of congenital pseudarthrosis of the tibia in China

et al. 2022

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“…[1][2][3]6,7,9,10,12,15 In this study, we reviewed the literature and all the studies that reported isolated congenital fibula pseudarthrosis as presented in Table 1 3 In the patients with nonunion of the fibula, osteosynthesis with an iliac corticocancellous graft was conducted 9 months postoperatively, and full union was obtained after 4 years of follow-up. 3 Two cases of isolated CPF were reported in 2019; 12 the first was a 13-year-old adolescent boy treated with osteosynthesis and internal fixation with a good outcome for 2 years without any complications. The second patient had Dooley type 3 of CPF, which was treated by tibial frontal osteotomy, distal tibiofibular fusion, and medial malleolus epiphysiodesis.…”

Section: Figurementioning

confidence: 99%

“…In this patient, the clinical and radiologic outcomes were favorable over a period of 4 years. 12 An important aspect of our study is the use of the periosteal flap technique without any bone grafts or permanent fixation devices. On radiographic evaluation, we found full union, and the patients did not complain of any pain or limping.…”

Section: Figurementioning

confidence: 99%

“…In previous studies, different treatment methods for this condition were recommended, but long-term outcomes were not reported. [1][2][3]6,7,9,10,12,15 In this study, we reviewed the literature and all the studies that reported isolated congenital fibula pseudarthrosis as presented in Table 1 3 In the patients with nonunion of the fibula, osteosynthesis with an iliac corticocancellous graft was conducted 9 months postoperatively, and full union was obtained after 4 years of follow-up. 3 Two cases of isolated CPF were reported in 2019; 12 the first was a 13-year-old adolescent boy treated with osteosynthesis and internal fixation with a good outcome for 2 years without any complications.…”

Section: Figurementioning

confidence: 99%

“… 6 , 11 Contrarily, the study by Martus and Johnston 9 found no ankle valgus in their cases and recommended against fusion of the tibia and fibula. Consequently, CPF can lead to ankle valgus and instability in the weight-bearing joint and joint osteoarthritis, 1 , 12 and for these reasons, many surgical techniques have been proposed.…”

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confidence: 99%

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Refracture, a Potential Complication of the Periosteal Flap Technique Without Bone Graft for Isolated Congenital Pseudarthrosis of the Fibula: A Report of Two Cases and Literature Review

Zargarbashi,

Ebrahimian,

Baghbabi

et al. 2023

JAAOS Glob Res Rev

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Background:It is a rare condition defined by congenital pseudarthrosis of the fibula (CPF), which may be associated with neurofibromatosis (NF) and congenital pseudarthrosis of the tibia. A condition such as this may be symptomatic or asymptomatic, but it requires treatment because of the progression of signs such as ankle valgus and pseudarthrosis of the tibia. There are a number of surgical techniques that can be used to treat this condition, such as tibiofibular fusion, internal fixation, the Ilizarov method, and periosteal flap.Aim:The goal of this study was to describe the treatment results of two patients with CPF using vascularized fibular periosteal flaps.Case report:We described the case of a 5-year-old patient and a 19-month-old patient with isolated CPF. Both patients underwent a distal-based vascularized fibular periosteal flap, and intramedullary fixation was used to treat the patients.Conclusion:The patients had full union in the pseudarthrosis site, but in the end, both had asymptomatic refracture in the union site. Our experiences showed that it is necessary to use strong intramedullary fixation and bone graft.

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Isolated congenital pseudarthrosis of the fibula: A report of two cases and review of the literature

Cited by 2 publications

References 11 publications

Epidemiological and clinical characteristics of congenital pseudarthrosis of the tibia in China

Epidemiological and clinical characteristics of congenital pseudarthrosis of the tibia in China

Refracture, a Potential Complication of the Periosteal Flap Technique Without Bone Graft for Isolated Congenital Pseudarthrosis of the Fibula: A Report of Two Cases and Literature Review

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