Management of Congenital Pseudarthrosis of the Tibia in Children Under 3 Years of Age: Effect of Early Surgery on Union of the Pseudarthrosis and Growth of the Limb

Benjamin Joseph, V. V.J. Somaraju, Sanath Kumar Shetty

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

The study was undertaken to determine whether the results of treatment of pseudarthrosis of the tibia in children under age 3 are so poor as to recommend that surgery be deferred until after 3 years of age. Radiographs and case records of 26 consecutive patients with Crawford type IV congenital pseudarthrosis of the tibia who were treated operatively were reviewed. Growth abnormalities of the tibia, fibula, and femur of the affected limb at presentation were identified. The outcome of treatment, in terms of union of the pseudarthrosis, refracture rate, and limb length, in 13 children treated operatively before age 3 years was compared with those operated on later. Union of the pseudarthrosis occurred in 12 of 13 children (92%) who were treated before 3 years of age by excision of the pseudarthrosis, intramedullary rodding, and dual-onlay cortical bone grafting. Union occurred in only five of seven children who underwent the same procedure between the ages of 3 and 12 years. The extent of shortening of the limb at the time of surgery was least in children younger than 3 years. The limb length discrepancy remained virtually static in 11 children who had transarticular Rush rodding before age 3. Growth abnormalities of the fibula, tibia, and femur were less pronounced in children operated on early. The study suggests that there is no need to defer surgery for pseudarthrosis of the tibia until the child is older than 3 years.

Original languageEnglish
Pages (from-to)740-746
Number of pages7
JournalJournal of Pediatric Orthopaedics
Volume23
Issue number6
DOIs
Publication statusPublished - 01-01-2003
Externally publishedYes

Fingerprint

Pseudarthrosis
Tibia
Extremities
Growth
Fibula
Femur
Inlays
Bone Transplantation

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine

Cite this

@article{240ddec8b2304ff6a201337d1db4b8e5,
title = "Management of Congenital Pseudarthrosis of the Tibia in Children Under 3 Years of Age: Effect of Early Surgery on Union of the Pseudarthrosis and Growth of the Limb",
abstract = "The study was undertaken to determine whether the results of treatment of pseudarthrosis of the tibia in children under age 3 are so poor as to recommend that surgery be deferred until after 3 years of age. Radiographs and case records of 26 consecutive patients with Crawford type IV congenital pseudarthrosis of the tibia who were treated operatively were reviewed. Growth abnormalities of the tibia, fibula, and femur of the affected limb at presentation were identified. The outcome of treatment, in terms of union of the pseudarthrosis, refracture rate, and limb length, in 13 children treated operatively before age 3 years was compared with those operated on later. Union of the pseudarthrosis occurred in 12 of 13 children (92{\%}) who were treated before 3 years of age by excision of the pseudarthrosis, intramedullary rodding, and dual-onlay cortical bone grafting. Union occurred in only five of seven children who underwent the same procedure between the ages of 3 and 12 years. The extent of shortening of the limb at the time of surgery was least in children younger than 3 years. The limb length discrepancy remained virtually static in 11 children who had transarticular Rush rodding before age 3. Growth abnormalities of the fibula, tibia, and femur were less pronounced in children operated on early. The study suggests that there is no need to defer surgery for pseudarthrosis of the tibia until the child is older than 3 years.",
author = "Benjamin Joseph and Somaraju, {V. V.J.} and Shetty, {Sanath Kumar}",
year = "2003",
month = "1",
day = "1",
doi = "10.1097/01241398-200311000-00011",
language = "English",
volume = "23",
pages = "740--746",
journal = "Journal of Pediatric Orthopaedics",
issn = "0271-6798",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

Management of Congenital Pseudarthrosis of the Tibia in Children Under 3 Years of Age : Effect of Early Surgery on Union of the Pseudarthrosis and Growth of the Limb. / Joseph, Benjamin; Somaraju, V. V.J.; Shetty, Sanath Kumar.

In: Journal of Pediatric Orthopaedics, Vol. 23, No. 6, 01.01.2003, p. 740-746.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Management of Congenital Pseudarthrosis of the Tibia in Children Under 3 Years of Age

T2 - Effect of Early Surgery on Union of the Pseudarthrosis and Growth of the Limb

AU - Joseph, Benjamin

AU - Somaraju, V. V.J.

AU - Shetty, Sanath Kumar

PY - 2003/1/1

Y1 - 2003/1/1

N2 - The study was undertaken to determine whether the results of treatment of pseudarthrosis of the tibia in children under age 3 are so poor as to recommend that surgery be deferred until after 3 years of age. Radiographs and case records of 26 consecutive patients with Crawford type IV congenital pseudarthrosis of the tibia who were treated operatively were reviewed. Growth abnormalities of the tibia, fibula, and femur of the affected limb at presentation were identified. The outcome of treatment, in terms of union of the pseudarthrosis, refracture rate, and limb length, in 13 children treated operatively before age 3 years was compared with those operated on later. Union of the pseudarthrosis occurred in 12 of 13 children (92%) who were treated before 3 years of age by excision of the pseudarthrosis, intramedullary rodding, and dual-onlay cortical bone grafting. Union occurred in only five of seven children who underwent the same procedure between the ages of 3 and 12 years. The extent of shortening of the limb at the time of surgery was least in children younger than 3 years. The limb length discrepancy remained virtually static in 11 children who had transarticular Rush rodding before age 3. Growth abnormalities of the fibula, tibia, and femur were less pronounced in children operated on early. The study suggests that there is no need to defer surgery for pseudarthrosis of the tibia until the child is older than 3 years.

AB - The study was undertaken to determine whether the results of treatment of pseudarthrosis of the tibia in children under age 3 are so poor as to recommend that surgery be deferred until after 3 years of age. Radiographs and case records of 26 consecutive patients with Crawford type IV congenital pseudarthrosis of the tibia who were treated operatively were reviewed. Growth abnormalities of the tibia, fibula, and femur of the affected limb at presentation were identified. The outcome of treatment, in terms of union of the pseudarthrosis, refracture rate, and limb length, in 13 children treated operatively before age 3 years was compared with those operated on later. Union of the pseudarthrosis occurred in 12 of 13 children (92%) who were treated before 3 years of age by excision of the pseudarthrosis, intramedullary rodding, and dual-onlay cortical bone grafting. Union occurred in only five of seven children who underwent the same procedure between the ages of 3 and 12 years. The extent of shortening of the limb at the time of surgery was least in children younger than 3 years. The limb length discrepancy remained virtually static in 11 children who had transarticular Rush rodding before age 3. Growth abnormalities of the fibula, tibia, and femur were less pronounced in children operated on early. The study suggests that there is no need to defer surgery for pseudarthrosis of the tibia until the child is older than 3 years.

UR - http://www.scopus.com/inward/record.url?scp=0142250813&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0142250813&partnerID=8YFLogxK

U2 - 10.1097/01241398-200311000-00011

DO - 10.1097/01241398-200311000-00011

M3 - Article

C2 - 14581777

AN - SCOPUS:0142250813

VL - 23

SP - 740

EP - 746

JO - Journal of Pediatric Orthopaedics

JF - Journal of Pediatric Orthopaedics

SN - 0271-6798

IS - 6

ER -