Treatment of congenital pseudarhrosis of tibia using axial bone graft on elastic splint, rh-BMP, compacted with cables and reconstructive plates

Abstract

Introduction: given the recalcitrant behaviour of pseudarthrosis in congenital pseudarthrosis of tibia (CPT) there is no ideal solution to treat such challenging deformities. Reconsideration of already known principles using modern technology may generate new treatment methods. Material and methods: the present paper presents the preliminary results of an original reconstruction procedure described by Prof. Dr. Gh. Burnei to treat large bone defects in paediatric orthopaedics. A case series study, the surgical technique, complications and illustrative cases are presented. Results: 4 cases of 18 patients having CPT, surgically treated between 1997 and 2012, were operated using this technique. The principles of the method is to create an optimal osteoconductive and osteoinductive environment using bone autograft, bone allograft and bone graft substitutes and to provide a good stabilisation of the bones. The follow-up period of the study group ranged from 2 to 17 years. Three of the 4 patients are able to ambulate. Conclusion: we believe that the present technique could be a reliable alternative to other procedures, especially in cases of repeated failures.