title: Congenital pseudoarthrosis of the tibia: healing by lengthening over a rod without compression of the nonunion. A preliminary report.
abstract: This preliminary report is on two patients with congenital pseudoarthrosis of the tibia who had a persistent nonunion following intramedullary rodding and bone grafting. We do not advocate repeated surgery to achieve union. When limb length discrepancy becomes greater than 5 cm, we proceeded with an Ilizarov procedure with the primary aim of equalizing limb length rather than achieving union. Healing of the pseudoarthrosis occurred in both patients after lengthening over the intramedullary rod without compression of the nonunion site. We believe that union occurs because of hyperaemia during the lengthening. This approach minimizes the repeated surgeries that are usually needed and thus ensures a more normal childhood without frequent hospitalizations.
authors.affiliation: Department of Orthopaedic and Traumatology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, Bandar Tun Razak, 560000 Cheras, Kuala Lumpur, Malaysia. drkortho@gmail.com
authors.forename: Muhammad Kamal
authors.initials: MK
authors.lastname: Muhammad Abdul Jamil
authors.forename: Abdul Halim
authors.initials: AH
authors.lastname: Abdul Rashid
authors.forename: Sharaf
authors.initials: S
authors.lastname: Ibrahim
mesh_terms: D016025:Bone Transplantation / Q000379:methods; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D018889:Ilizarov Technique; D016268:Internal Fixators; D008297:Male; D009456:Neurofibromatosis 1 / Q000150:complications / Q000175:diagnosis; D011542:Pseudarthrosis / Q000151:congenital* / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D011859:Radiography; D012086:Reoperation; D018570:Risk Assessment; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D016896:Treatment Outcome