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Forearm pseudarthrosis--neurofibromatosis: case report.

P R Manske

    Clinical Orthopaedics and Related Research
    |March 1, 1979
    PubMed
    Summary
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    This case study highlights a challenging pediatric forearm fracture with neurofibromatosis. Surgical intervention for pseudarthrosis is recommended only after skeletal maturity is reached.

    Area of Science:

    • Orthopedic Surgery
    • Pediatric Orthopedics
    • Genetic Disorders

    Background:

    • Neurofibromatosis (NF) is a genetic disorder that can lead to bone abnormalities and increased fracture risk.
    • Pediatric long bone fractures, especially in patients with underlying conditions like NF, can present complex challenges in achieving union.
    • Pseudarthrosis, or failure of bone to unite, is a significant complication that requires careful management.

    Observation:

    • A 3 1/2-year-old girl with neurofibromatosis experienced fractures of the radius and ulna.
    • Initial conservative treatment and three subsequent surgical attempts failed to achieve union, resulting in persistent pseudarthrosis.
    • The patient's forearm was managed non-operatively until skeletal maturity at age 13 1/2.

    Findings:

    Related Experiment Videos

  • Delayed surgical intervention using dual onlay tibial bone grafts successfully achieved osseous union in the forearm pseudarthrosis.
  • No recurrence of pseudarthrosis was noted at over 3 years post-operatively.
  • This case demonstrates the potential for successful surgical union in complex pediatric pseudarthrosis after reaching skeletal maturity.

    • Implications:

    • Postponing surgical management of forearm pseudarthrosis associated with neurofibromatosis until skeletal maturity may improve outcomes.
    • This approach may reduce the need for multiple revision surgeries and associated complications in pediatric patients.
    • Further research into optimal timing and techniques for managing NF-associated bone defects is warranted.