Paley Cross-Union Protocol for Treatment of Congenital Pseudarthrosis of the Tibia

Paley, Dror

doi:10.1016/j.oto.2021.100881

Cited by 11 publications

(22 citation statements)

References 21 publications

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“…Although the experience with new procedure is limited to few series (five studies), the same has been quite encouraging. The union can be practically assured in every case in the expert hands following use of the technique (Choi et al [31] and Paley [55]). The technique boasts of a shorter union time (as low as 4.5 months) and has found application in much younger children (average 4 years).…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment options for congenital pseudarthrosis of tibia in children: cross-union versus other options: a systematic review

Rastogi

Agarwal

2021

Journal of Pediatric Orthopaedics B

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The systematic review aimed to provide a comprehensive update on various surgical treatment options for congenital pseudarthrosis of tibia (CPT) in children and the outcome achieved in terms of union, union time and complications of non-union and refracture. A literature search was performed in PubMed (including Medline) database for broad keywords: 'Congenital pseudarthrosis of tibia and children'. Studies selected included full-text articles on surgical treatments of CPT following: intra-medullary rod (IMR)/Ilizarov/ combined IMR with Ilizarov/vascularized fibular graft (VFG) and cross-union. Out of 719 studies, 57(1227 CPT patients/1235 tibias) were included for review. Cross-union group had 100% union rate with no nonunions, least refracture rate (22.5%) and minimal time to primary union (4.5 months). For IMR, Ilizarov, combined IMR with Ilizarov and VFG, the respective results were as follows:

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Section: Discussionmentioning

confidence: 99%

Surgical treatment options for congenital pseudarthrosis of tibia in children: cross-union versus other options: a systematic review

Rastogi

Agarwal

2021

Journal of Pediatric Orthopaedics B

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“…Potential risks of BMP-2 are uncommon and primarily related to instances of excessive swelling, making it a suitable and safe therapeutic option to promote bone healing in children and adolescents. 26 The combination of correction of abductor contracture, proximal femur flexion, and coxa vara together along with soft-tissue balancing is called the SUPERhip procedure 9 and may include BMP-2 administration to reduce delayed ossification and recurrent varus. Advancement of hip abductors is thought to improve weakness.…”

Section: Management Considerationsmentioning

confidence: 99%

“…The Paley CFD classification is meant to guide surgical management of CFD. 9 It contains four categories with subtypes progressing similarly from least to most severe (Table 2; Figure 2).…”

Section: Classificationmentioning

confidence: 99%

“…These are points included in Paley's more recent classification system and important determinants of surgical reconstructive options. 9 The presence of a mobile femoral head attached to the femur suggests a more straightforward anatomic reconstruction. If the femoral head is disconnected or fused to the acetabulum, the proximal deficiency and length discrepancy are usually more severe.…”

Section: Management Considerationsmentioning

confidence: 99%

“…Diagnoses of campomelic syndrome and femoral hypoplasia with unusual facial features syndrome should additionally be considered with bilateral presentation. 9…”

Section: Management Considerationsmentioning

confidence: 99%

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Proximal Femoral Focal Deficiency/Congenital Femoral Deficiency: Evaluation and Management

Nossov

Hollin

Phillips

et al. 2022

J Am Acad Orthop Surg

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Proximal focal femoral deficiency is a congenital transverse deficiency in which the femur is globally smaller with a typical proximal deformity at the hip that may include distal involvement of knees, leg, and feet. Congenital femoral deficiency (CFD) describes a broader spectrum of longitudinal deficiency inclusive of proximal focal femoral deficiency. CFD may also include lateral distal femoral hypoplasia, knee cruciate ligament deficiency, rotational instability, patellar dislocation, fibular hemimelia, ray absence, and contralateral limb involvement. Treatment intends to maximize function by limb equalization and deformity correction ranging from nonsurgical management using prosthetics to amputation and may include lengthening, shortening, and complex limb reconstruction. Management decisions depend on overall severity and the patient and family's preferences and priorities. Owing to its complexity, CFD is best treated by clinicians with considerable deformity treatment experience who can help guide decision making and embark on a treatment course that will maximize the functional outcome.

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Etiology of Lower Limb Deformity

Zakrzewski,

Jain

2024

Pediatric Lower Limb Deformities

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Paley Cross-Union Protocol for Treatment of Congenital Pseudarthrosis of the Tibia

Cited by 11 publications

References 21 publications

Surgical treatment options for congenital pseudarthrosis of tibia in children: cross-union versus other options: a systematic review

Surgical treatment options for congenital pseudarthrosis of tibia in children: cross-union versus other options: a systematic review

Proximal Femoral Focal Deficiency/Congenital Femoral Deficiency: Evaluation and Management

Etiology of Lower Limb Deformity

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