Complex Decisions in the Management of Congenital Pseudarthrosis of the Tibia Panel Discussion
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Abstract
Congenital pseudarthrosis of the tibia, or congenital tibial dysplasia, is one of the most challenging conditions in pediatric orthopaedics. In children who present in a pre-fracture state, the initial goal is fracture prevention. Once the tibia has fractured, the goals of treatment pivot to achieving – and maintaining – union. Treatment approaches are varied and may include: pseudarthrosis resection, intramedullary(IM) fixation, circular external fixation, internal fixation, vascularized fibular grafting, biologics, guided growth, or a combination of approaches. Unfortunately, the treatment of this condition is often fraught with complications and it is not unusual for a child to undergo multiple procedures.
The goals of this case discussion are to highlight how experts approach these complex cases, to emphasize the key components of decision-making, to demonstrate clinical and technical pearls, and to feature the heterogeneity of this condition and its treatment.