title: Treatment of congenital pseudarthrosis of the tibia with vascularized fibular periosteal transplant.
abstract: The vascularized fibular periosteal flap has been recently described and showed solid angio and osteogenic features. We report the use of a free vascularized fibular periosteal transplant in the treatment of a El-Rosasy-Paley Type III congenital pseudarthrosis of the tibia in a 7-year-old boy, with a prior unsuccessful surgery at the age of three. The contralateral fibular periosteum was used to replace two-thirds of the hamartomatous tibial periosteum. We did not proceed to debriding the focus of the pseudarthrosis nor addressed the tibial recurvatum or revised the previous tibial rod. Consolidation was achieved radiologically at 3 months, allowing for the tibial rod to be removed. One year postoperatively, the patient ambulated without the use of a protective orthesis and resumed his sports practice. This novel pathogenesis-based technique showed promising results and a prompt healing of such a difficult orthopedic condition.
authors.affiliation: Pediatric Hand Surgery and Microsurgery, Orthopaedic Surgery Department, Hospital Universitari Vall 'Hebron, Universitat Autònoma de Barcelona, Institut de Recerca (VHIR), Barcelona, Spain. xsoldado@gmail.com
authors.forename: Francisco
authors.initials: F
authors.lastname: Soldado
authors.forename: Cesar
authors.initials: C
authors.lastname: Garcia Fontecha
authors.forename: Sleiman
authors.initials: S
authors.lastname: Haddad
authors.forename: A
authors.initials: A
authors.lastname: Hernandez-Fernandez
authors.forename: Pablo
authors.initials: P
authors.lastname: Corona
authors.forename: Ernesto
authors.initials: E
authors.lastname: Guerra-Farfan
mesh_terms: D002648:Child; D005360:Fibula / Q000637:transplantation*; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D010521:Periosteum / Q000637:transplantation*; D011542:Pseudarthrosis / Q000151:congenital* / Q000601:surgery; D013977:Tibia / Q000473:pathology / Q000601:surgery*