Case 32: Fourteen Year Old Patient with Severe Congenital Pseudarthrosis of the Tibia

Abstract

This is a case of a 14 year old patient with a severe, neglected congenital pseudarthrosis of the tibia (CPT). She did not have any prior treatment for this condition. She underwent excision of the pseudarthrosis, application of a hybrid Ilizarov – Taylor Spatial Frame, autogenous bone grafting, and OP-1 application. She had five subsequent surgeries until bony fusion was obtained. The last surgery included the insertion of an intramedullary female Fassier-Duval rod through the ankle joint. Associated problems included a limb discrepancy of 14 cms. After obtaining fusion at the pseudarthrosis site, she underwent femoral lengthening of 8 cms and is functioning now with a shoe lift. This case exemplifies the complexity and numerous challenges in the management of CPT.