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Are Children Suffering From Congenital Pseudarthrosis of the Tibia Associated With Decreased Bone Strength?

Ge Yang1, Siyu Xu1, Haibo Mei1

  • 1Department of Pediatric Orthopedics, The Hunan Children's Hospital, Changsha, China.

Frontiers in Pediatrics
|May 26, 2022
PubMed

Insights

Congenital pseudarthrosis of the tibia (CPT) is linked to reduced bone strength in children. Higher CPT severity correlates with lower bone strength and increased fracture risk, independent of neurofibromatosis type 1.

Area of Science:

  • Pediatric Orthopedics
  • Biomedical Engineering
  • Skeletal Diseases

Background:

  • Congenital pseudarthrosis of the tibia (CPT) is a rare neonatal condition.
  • Previous research indicated CPT-derived exosomes inhibit bone formation.
  • This study investigates bone strength in children with CPT using ultrasound bone densitometry.

Purpose of the Study:

  • To compare bone strength in children with CPT versus those with non-metabolic diseases.
  • To identify factors associated with bone strength variations in CPT patients.
  • To assess the relationship between CPT severity and bone strength.

Main Methods:

  • Recruited 37 children with CPT and 40 controls (non-bone metabolic disease).
  • Utilized ultrasonic bone densitometry to measure calcaneal broadband ultrasonic attenuation (BUA), speed of sound (SOS), quantitative ultrasound index (QUI), bone strength index (STI), and bone mineral density estimation (BMDe).
  • Employed multivariable regression to analyze associations with age, BMI, NF1, and CPT Crawford type.

Main Results:

  • CPT patients showed significantly lower SOS, STI, QUI, and BMDe compared to controls.
  • Multiple regression analysis revealed negative correlations between SOS, STI, QUI, and CPT Crawford classification.
  • Decreased bone strength incidence was higher in the CPT group.

Conclusions:

  • Children with CPT exhibit reduced bone strength compared to controls.
  • Bone strength reduction is linked to CPT severity (Crawford classification), not NF1.
  • Higher CPT Crawford classification grades indicate lower bone strength and increased fracture risk.
Abstract

Keywords:
bone mineral density estimationbone qualitycongenital pseudarthrosis of the tibiaquantitative ultrasoundultrasonic bone densitometer

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