Reconstructive surgery in the treatment of congenital pseudarthrosis of the tibia in children using microsurgical techniques: Reconstruction or amputation?

BACKGROUND: Numerous methods are available for the treatment of congenital pseudarthrosis tibia, but none them offers a 100% satisfactory result and does not exclude development repeated refractories. One is vascularized transplantation fragment fibula into position defect tibia. However, achievement consolidation bone fragments lower leg stop series interventions necessary to restore function affected segment. Therefore, specialists were asked about advisability performing amputations as an alternative long-term multistage interventions.
 AIM: To analyze results use microsurgical techniques patients with tibia and, using example patient, show way reconstruction limb.
 MATERIALS AND METHODS: The in elimination bones five analyzed. Age, sex, presence type 1 neurofibromatosis, size, autograft duration consolidation, osteosynthesis index, refractory, range joint motion, secondary deformities segments after assessed. course patient when severe reconstructive weight-bearing capacity limb was described. Vascularized performed by qualified team.
 RESULTS: mean age 7.8 2.2 years. Boys predominated, neurofibromatosis detected 60% cases. average size 8.8 1.6 cm, 10.8 cm. fixation 260 90 days, index 24.6 10.6 days/cm. In two cases, year transfer, refractories noted at bonegraft interface. had fibrous ankylosis level ankle joint, loss functional 40% there flexionextension contractures knee joints extension deficit up 20. For this observation period, 3 5 underwent additional surgical correct CONCLUSIONS: VFT allows restoring integrity Multiple on same segment can lead irreversible changes adjacent limb.