ABSTRACT
The present study compares a recent approach for congenital pseudarthrosis of the
tibia, combining a free vascularized fibula graft and an Ilizarov external fixator.
Between 1984 and 1993, seven vascularized fibula grafts were performed. In the first
six cases, casts or unilateral external fixators were applied, and five of these cases
were complicated by fractures of the graft, necessitating secondary procedures or
long-term immobilization. The mean follow-up was 12.1 years. Five patients can now
walk unassisted, and one uses a brace only outdoors. On average, a brace was required
for 18 months. In the recent Ilizarov external fixator case, the fixator was removed
after 4 months and a brace was unnecessary at 10 months. There was no leg-length discrepancy,
severe ankle deformity, or fracture of the grafted fibula 7 years postoperatively.
Combining a free vascularized fibula graft with an Ilizarov external fixator is recommended
for this condition.
KEYWORD
Congenital pseudarthrosis of the tibia - free vascularized fibula graft plus Ilizarov
external fixator
