[Congenital pseudarthrosis of the tibia]

Congenital pseudarthrosis of the tibia (CPT) is one of the most challenging conditions in paediatric orthopaedics. The history of CPT treatment is characterised by repeatedly ineffective surgical interventions with the inevitable outcome of severe disability. Most procedures failed to account for the complexity of the problem. The past two decades have witnessed more experience having been gained with the Ilizarov technique. This method provides a comprehensive approach to all aspects of CPT problem, allowing the surgeon to simultaneously address the problems of union as well as those of deformity, length discrepancy joint function, ankle valgus and weight bearing. It appears that the goal to achieve stable fusion before the child begins school is attainable. In the pre-pseudoarthrotic stage, bracing should be preferred to surgery until the patient is in an older age group. This study reports on the results of 19 patients: 15 have finished treatment, and 14 of them with a stable fusion at follow-up. The results were highly encouraging in reaching the ultimate goal of avoiding amputation and achieving a well-functioning limb.