RECONSTRUCTION OF CONGENITAL TIBIAL PSEUDOARTHROSIS BY REVASCULARIZEDFIBULAR TRANSPLANTS

Seven patients with congenital Boyd type II pseudarthrosis of the tibi a and fibula were treated with a revascularized osteocutaneous fibular graft from the contralateral side. Follow-up ranged from 20 to 96 mon ths (mean 67 months). All patients had previously undergone major surg ery (mean three operations). Union was successful in all patients alth ough three required further surgery. At follow-up all patients were ab le to walk without external support. The results were classified as go od in two cases and fair in five cases. The postoperative period was, however, often complicated by stress-fracture and nonunion. Leg length discrepancy and valgus deformity are still unsolved problems in some cases. It seems probable that a primary reconstruction at an early age will prevent many of these subsequent problems. (C) 1993 Wiley-Liss, Inc.