Clinical Study Of The Monolateral External Fixator For Treatment Of The Congenital Pseudarthrosis Of The Tibia

ObjectiveTo compare the clinical effects of the use of monolateral external fixator and vascularized fibular graft(VFG)for treatment of the congenital pseudarthrosis of the tibia(CPT),provide evidence for clinical reasonable select therapy.MethodA retrospective study was carried out in 19 patients who are treated with the monolateral external fixator or VFG for congenital pseudarthrosis of the tibia.5 boys and 6 girls were treated with the monolateral external fixator,average age at 6.0years(range:1.1～11.2years).3 boys and 5 girls were treated by vascularized fibular grafting,average age at 7.0 years(range:1.9-11.5 years).ResultsAll patients were followed-up.1.Monolateral external fixator group:Followed-up for average 6.4years(range:2.8～7.6years),Bone consolidation was obtained in all cases after an average term of 5.9months(range:4～8months),The initial bone consolidation rate was 100%.Refracture occurred in 1.Leg-length discrepancy＞2cm occurred in 7.There were 2 of the patients show residual deformity with the tibial valgus and/or anterior bowing＞20°.2.VFG group:Followed-up for average 11.7 years(range:4.9～ 19.6years),Bone consolidation was obtained in all cases after an average term of 6.6 months(range:4-10 months);this was with the first VFG in 7 cases but with the second VFG in 1 case.The initial bone consolidation rate was 88%.Refracture occurred in 1.Leg-length discrepancy＞2cm occurred in 5.Residual deformity with the tibial valgus and/or anterior bowing＞20°occurred in 4.ConclusionVFG is generally acknowledged as an ideal method for CPT nowadays.According to the result of this study,use the Monolateral external fixator for the treatment of CPT is an acceptable method as well.