title: Induced membrane technique for the treatment of congenital pseudarthrosis of the tibia: preliminary results of five cases.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the two-stage surgical technique combining induced membrane, spongy autograft and intramedullary fixation for the treatment of congenital pseudarthrosis of the tibia (CPT).
  
  
  METHODS
  Three boys and two girls were treated by this technique between 2003 and 2008. All patients had type IV CPT in Crawford's classification. Four of them had a limited dystrophic form, whereas one case presented an extensive tibia bone dystrophy. The average age of patients at the time of surgery was 23 months (range 10-30 months), with an average follow-up of 5.8 years (range 2.4-8.1 years).
  
  
  RESULTS
  Satisfactory tibial bony union was achieved in all cases at the last follow-up. Bone healing was obtained in the four limited forms after an average term of 4 months. One patient suffered from a non-displaced fracture that healed by casting in a usual period of time. The patient with an extensive dystrophic bone had to undergo a secondary inter-tibiofibular bone graft to finally achieve bone union.
  
  
  CONCLUSIONS
  The preliminary results show that this technique is successful in CPT. It may be used even in young children and offers a good alternative to other treatments available, avoiding external fixation and the technical difficulties of microvascular surgery.
authors.affiliation: Department of Pediatric Orthopedics, Université Paris Descartes, Sorbonne Paris Cité, Hôpital Necker Enfants Malades, 149 rue de Sèvres, 75015 Paris, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Pannier
authors.affiliation: Department of Pediatric Orthopedics, Université Paris Descartes, Sorbonne Paris Cité, Hôpital Necker Enfants Malades, 149 rue de Sèvres, 75015 Paris, France.
authors.forename: Zagorka
authors.initials: Z
authors.lastname: Pejin
authors.affiliation: Department of Pediatric Orthopedics, Université Paris Descartes, Sorbonne Paris Cité, Hôpital Necker Enfants Malades, 149 rue de Sèvres, 75015 Paris, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Dana
authors.affiliation: Department of Orthopedic Surgery, Université Paris XIII, Hôpital Avicenne, Bobigny, France.
authors.forename: Alain Charles
authors.initials: AC
authors.lastname: Masquelet
authors.affiliation: Department of Pediatric Orthopedics, Université Paris Descartes, Sorbonne Paris Cité, Hôpital Necker Enfants Malades, 149 rue de Sèvres, 75015 Paris, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Glorion
keywords: Congenital pseudarthrosis of the tibia; Induced membrane