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11 April 2018 : Case report  Jordan

Anterolateral Bowing of Congenital Pseudoarthrosis of Tibia Treated by Percutaneous Osteotomy and Gradual Correction Using Taylor Spatial Frame, then Late Insertion of a Fussier-Duval Nail: A Case Report

Unusual or unexpected effect of treatment

Rami Jahmani1ABEF*, Mohammed Alorjani2E

DOI: 10.12659/AJCR.908482

Am J Case Rep 2018; 19:426-430

Abstract

BACKGROUND: Congenital pseudoarthrosis of the tibia is one of the most difficult orthopedic diseases to treat. Many authors consider osteotomy of the bowed non-broken tibia a contraindication. However, leaving the patient with a deformed, bowed leg is intolerable and is associated with deformity progression and increased risk of fracture.

CASE REPORT: A 12-year-old boy presented with a bowed leg. X-ray tibia showed partially healed congenital pseudoarthrosis of the tibia and 30 degrees of flexion deformity. Deformity was successfully treated by percutaneous osteotomy made through the site of congenital pseudoarthrosis and gradual correction using a computer-assisted external fixator, the Taylor spatial frame (TSF; Smith and Nephew, Memphis, TN). At the end of the correction, a telescopic Fassier-Duval intramedullary nail was used prophylactically to prevent re-fracture. After 2 years of follow-up, X-ray images show bone-healing without any bowing.

CONCLUSIONS: Closed percutaneous osteotomy, without excision of the pseudoarthrosis, and gradual correction then insertion of Fassier-Duval telescopic nail may serve as a treatment to correct deformed bone in congenital pseudoarthrosis of the tibia.

Keywords: Congenital Abnormalities, External Fixators, Osteotomy, Pseudarthrosis, Tibia, Bone Nails

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923