The fibula in congenital pseudoarthrosis of the tibia: The EPOS Multicenter Study

Fibular involvement in congenital pseudoarthrosis of the tibia (CPT) can be either a rare isolated pathology or is in association with the tibial chan ges. Out of 282 patients with CPT who had complete radiographic work-up, 62 % (almost two thirds) demonstrated fibular pathology: 36% had true fibular pseudoarthrosis and the rest, i.e., 26% had fibular hypoplasia or dysplasti c fibula. Neurofibromatosis was found in 62% of the patients with fibular p athology. The typical radiological features of tibial pseudoarthrosis are o ften missing in patients with fibular pathology. It is most probably becaus e fibular changes precede the tibial involvement. In 250 patients with tibi al surgical treatment, the highest rate of fusion occurred in patients with fibular involvement compared with those with normal fibula.