Treatment of a case of congenital pseudarthrosis of the tibia-fibular osteosynthesis

We report the results of a case of congenital pseudarthrosis of the tibia t reated by tibiofibular synthesis. A 1-year old girl was first treated by in tramedullary fixation followed by an intertibiofibular bone graft. This met hod failed. She then underwent a new operation that was associated two simu ltaneous approaches, correction of the axis, tibiofibular synthesis and a n ew intertibiofibular bone graft. Union was achieved four months later. The child has now been followed up for 20 years. During this time, she has led a normal life as we have observed a "tibialisation" of the fibula. Intramed ullary fixation has a success rate of 75 % but requires repetitive insertio n of intramedullary or telescopic rods. Transplantar intramedullary rods ar e responsible for significant ankle stiffness. Tibiofibular synthesis assoc iated with an intertibiofibular bone graft after correction of the axis is the equivalent of vascularised graft of the fibula but with neither the dif ficulties of microsurgery nor valgus deformities of the ankle.