A rare case report of congenital pseudoarthrosis of tibia and fibula managed with dual modality of treatment: Ilizarov external fixator and plate osteosynthesis

Abstract

Congenital pseudoarthrosis is specific kind of non-union that is either present or developing at birth. Though its cause is unknown, it commonly affects people with neurofibromatosis. The most common sites of congenital pseudoarthrosis are the distal portion of the tibia and commonly the fibula of the same leg. Approximately one in 250,000 live pregnancies results in congenital pseudarthrosis of the tibia. A 4-year-old child with a history of his right leg being shorter since, birth and being unable to use it for walking arrived at the orthopaedic outpatient clinic. The patient was managed with resection of the callus and pseudoarthrosis site and the tibia shaft was fixed with low contact dynamic compression locking device. The Ilizarov ring fixator was used and corticotomy was performed at the junction of the proximal and middle tibial shafts in order to lengthen the leg using the distraction osteogenesis principle. The goal of surgical therapy is to achieve pseudoarthrosis bone union while restoring limb alignment in order to lessen the risk of a subsequent fracture and keep bone development and function in the leg. It appears as CPT and is commonly accompanied with distinctive anterolateral bending. The Ilizarov procedure offers patients with CPT a therapeutic choice that is secure, useful and realistic. It can achieve a number of goals, including ankle stability, osteosynthesis and leg-length equality, when compared to alternative therapy methods. The fixation technique using a locking compression plate along with a bone graft improves the treatment of complicated congenital pseudarthrosis of the tibia.