G Ian Taylor, Russell J Corlett, Mark W Ashton
BACKGROUND: The first successful free vascularized bone flap was performed on June 1, 1974 (and reported in 1975), using the fibula. This was followed by the iliac crest based on the superficial circumflex iliac artery in 1975 and then the deep circumflex iliac artery in 1978. METHODS: A total of 384 transfers using fibula (n = 198), iliac crest (n = 180), radius (n = 4), rib (n = 1), and metatarsal (n = 1) were used between June of 1974 and June of 2014 for reconstruction of the mandible (n = 267), maxilla (n = 20), clavicle (n = 1), humerus (n = 8), radius and ulna (n = 21), carpus (n = 3), pelvis (n = 2), femur (n = 11), tibia (n = 47), and foot bones (n = 4)...
April 2016: Plastic and Reconstructive Surgery
Sang Gyo Seo, Dong Yeon Lee, Yeon Soo Kim, Won Joon Yoo, Tae-Joon Cho, In Ho Choi
BACKGROUND: The purpose of this study was to evaluate clinical outcomes and the biomechanical function of the foot and ankle at skeletal maturity of patients treated for atrophic-type congenital pseudarthrosis of the tibia (CPT) compared with healthy young adult controls. METHODS: Twenty-four patients (mean age of 19.1 years) who had undergone Ilizarov treatment for unilateral atrophic-type CPT were compared with twenty-four controls (mean age of 19.6 years). All participants were evaluated using validated outcome questionnaires, radiographs, physical examination, instrumented motion analysis including a multisegmental foot model, and pedobarographic measurement...
March 16, 2016: Journal of Bone and Joint Surgery. American Volume
A Carlier, H Brems, J M A Ashbourn, I Nica, E Legius, L Geris
Congenital pseudarthrosis of the tibia (CPT) is a rare disease which normally presents itself during early childhood by anterolateral bowing of the tibia and spontaneous tibial fractures. Although the exact etiology of CPT is highly debated, 40-80% of CPT patients are carriers of a mutation in the Neurofibromatosis Type 1 (NF1) gene, which can potentially result in an altered phenotype of the skeletal cells and impaired bone healing. In this study we use a computational model of bone regeneration to examine the effect of the Nf1 mutation on bone fracture healing by altering the parameter values of eight key factors which describe the aberrant cellular behaviour of Nf1 haploinsufficient and Nf1 bi-allelically inactivated cells...
January 29, 2016: Scientific Reports
Dmitry Y Borzunov, Alexander Y Chevardin, Alexander I Mitrofanov
PURPOSE: Our study compared the rates of union achieved with the Ilizarov method in congenital pseudarthrosis of the tibia (CPT) associated with neurofibromatosis type 1 (NF1) or CPT of idiopathic origin in paediatric patients. METHODS: We studied the outcomes of 28 children that were treated for CPT between 2005 and 2013. Group 1 included children (n = 14, mean age = 9.7 years) with CPT associated with NF1 while group 2 were CPT cases that had radiographic confirmation of dysplastic lesions in the tibia but lacked clinical NF1 manifestations (n = 14, mean age = 8...
February 2016: International Orthopaedics
Toni M Mansour, Ismat B Ghanem
BACKGROUND: During past decades, gradual bone transplant using external fixators and vascularized fibular or rib transplants widely contributed to solve difficult problems related to the reconstruction of large bone defects in children. However, these surgeries are time consuming and require specialized surgical skills, not always available in a general hospital setting, mainly in rural areas. PURPOSE: To report the preliminary results of the more recently described induced membrane technique in a consecutive series of 8 children and to identify some factors related to the procedure's success...
January 2017: Journal of Pediatric Orthopedics
Kaushik Bhowmick, Viju Daniel Varghese
We present the case of a 23-year-old male with congenital pseudarthrosis of the tibia, who had undergone treatment with Ilizarov ring fixation and had experienced 4 episodes of repeat fracture. He had associated type 1 neurofibromatosis, and his radiographs confirmed a type 6 Boyd's congenital pseudarthrosis of the left tibia, with concomitant arthritic ankle and subtalar joints. He was treated successfully with retrograde intramedullary nailing of the tibia and autologous bone grafting. At his final follow-up visit at 3 years postoperatively, he displayed complete union with no repeat fractures...
November 2016: Journal of Foot and Ankle Surgery
Guang-hui Zhu, Hai-bo Mei, Rong-guo He, Kun Liu, Jin Tang, Jiang-yan Wu
BACKGROUND: The purpose of our retrospective study was to evaluate the preliminary result of distraction osteogenesis in patient with tibial shortening after initial union of Congenital Pseudarthrosis of the Tibia (CPT). METHODS: All the CPT cases with tibial shortening after initial union managed by proximal tibial lengthening using Ilizarov technique were identified. All the patient charts and radiograms were reviewed. RESULTS: Between March 2007 and January 2012, 11 CPT cases were included with an average follow-up of 41 months (range, 34-51 months)...
August 21, 2015: BMC Musculoskeletal Disorders
Jan Vanderstappen, Johan Lammens, Pieter Berger, Armand Laumen
PURPOSE: Most studies on congenital pseudarthrosis of the tibia (CPT) report on the short-term union rate and refracture rate but do not take into account the long-term outcome. This review includes patients treated with an Ilizarov bone transport, who all reached skeletal maturity. It describes long-term results and highlights any prognostic factors that could predict the final outcome. METHODS: The records of patients with CPT treated with an Ilizarov bone transport in our institution were retrospectively evaluated...
August 2015: Journal of Children's Orthopaedics
Lior Shabtai, Eli Ezra, Shlomo Wientroub, Eitan Segev
Ten children with congenital pseudarthrosis of the tibia were treated with resection of pathologic bone, bone grafting, intramedullary rodding, compression with circular frame, simultaneous proximal tibia lengthening, and bone morphologic proteins. Thirteen operations were performed to achieve union. Four patients underwent simultaneous lengthening and four patients received recombinant human bone morphologic protein. Six children required complementary operations for residual ankle and knee valgus, and shortening...
September 2015: Journal of Pediatric Orthopedics. Part B
B Stephens Richards, David Wilkes, Molly Dempsey, Pamela Nurenberg
The aim of this study was to determine whether an established radiographic union scoring system for tibial fracture healing (RUST) is reliable when used in neurofibromatosis (NF1) patients with congenital pseudarthrosis of the tibia (CPT) treated by intramedullary fixation. Four individuals reviewed 36 sets of radiographs from 12 NF1 patients with CPT (preoperative, and 6 months and 1 year postoperative). Intraobserver reliability (κ-value 0.89) and interobserver reliability (κ-value 0.76) were high. The modified RUST scoring system is a useful tool when faced with the challenge of postoperative radiographic evaluation of the tibia in NF1 patients with CPT...
March 2015: Journal of Pediatric Orthopedics. Part B
C E Johnston
No abstract text is available yet for this article.
March 1, 1983: Orthopedics
A Vilks, D Ozols, V Boka, M Murovska, B Mamaia
Neurofibromatosis type-1 (NF-1)--is a common genetic disease effecting the skin, subcutaneous tissue peripheral nerves and bones (tibia pseudarthrosis). Immunomodulatory viruses HHV-6 and HHV-7 are classifying as a genus of roseoloviruses of subfamily beta-herpesviruses. Reactivation of HHV-6 and HHV-7 inhibits immune system and indirectly promote to other infectious agents. The article deals with a unique case repot of two repeated transplantations of fibula due to congenital tibia pseudarthrosis caused by NF-1...
January 2014: Anesteziologiia i Reanimatologiia
Zoran Vukasinović, Dusko Spasovski, Igor Seslija, Ismet Gavrankapetanović, Elvir Bazdar, Zorica Zivković
INTRODUCTION: Congenital pseudarthrosis of tibia is a rare congenital deformity with progressive evolution. Treatment is vague and difficult, and many methods have been used--from once mandatory early amputation to contemporary operative (Ilizarov method, free microvascular fibular graft) and adjuvant methods (electrostimulation, biphosphonates, bone morphogenetic protein). We present the usage of once popular method of homologous graft insertion and intramedullary fixation. CASE OUTLINE: This is a case report of male patient with pseudarthrosis involving both crural bones (Boyd type 5), diagnosed in neonatal age...
January 2014: Srpski Arhiv za Celokupno Lekarstvo
Husam Alrumaih, Imran Ilyas, Syed Kashif
PATIENT: Male, 43 FINAL DIAGNOSIS: Neurofibromatosis Symptoms: Hip pain Medication: - Clinical Procedure: - Specialty: Orthopedics and Traumatology. OBJECTIVE: Rare disease. BACKGROUND: Neurofibromatosis type 1 is a disease known for orthopedic manifestations such as spine deformities, congenital pseudarthrosis of the tibia and other bony dysplasias; joint dislocations are rare. Joint arthritis caused by neurofibromatosis, with a stable hip, has never been reported in the English literature before...
2014: American Journal of Case Reports
Stéphanie Pannier, Zagorka Pejin, Caroline Dana, Alain Charles Masquelet, Christophe Glorion
PURPOSE: The purpose of this study was to evaluate the two-stage surgical technique combining induced membrane, spongy autograft and intramedullary fixation for the treatment of congenital pseudarthrosis of the tibia (CPT). METHODS: Three boys and two girls were treated by this technique between 2003 and 2008. All patients had type IV CPT in Crawford's classification. Four of them had a limited dystrophic form, whereas one case presented an extensive tibia bone dystrophy...
December 2013: Journal of Children's Orthopaedics
N Nicolaou, A Ghassemi, R A Hill
PURPOSE: This retrospective cohort study assesses the outcomes of a protocol of management, based on the recommendations of the European Paediatric Orthopaedic Society (EPOS) multi-centre study, for the management of congenital pseudarthrosis of the tibia. METHODS: Utilising an incremental protocol of bracing, intramedullary rods and circular frame fixation with or without bone morphogenetic protein-2 (BMP-2), 11 patients had reached skeletal maturity or had follow up of 5 years from radiological union of the pseudarthrosis...
October 2013: Journal of Children's Orthopaedics
Joachim Horn, Harald Steen, Terje Terjesen
PURPOSE: Congenital pseudarthrosis of the tibia (CPT) is a rare disease. Epidemiological data are limited, and treatment of the condition is challenging. The purpose of our study was to gain epidemiological data on the incidence of CPT in Norway and to evaluate the treatment outcome of the disease. METHODS: During the period 1987-2006 22 patients with CPT were born in Norway (11 boys, 11 girls; mean age 15 years, age range 8-24 years) and are included in this study...
March 2013: Journal of Children's Orthopaedics
Shahid Hameed, Rana Hassan Javaid Ehtesham-ul-haq, Rao Saood Ahmed, Abdul Majid, Muhammad Waqas, Ayesha Aslam, Omamah Yusuf, Ahsin Masood Butt, Ghazanfar Ali
The case series was conducted at the Department of Plastic Surgery, Combined Military Hospital, Rawalpindi, from June 2009 to May 2011, and comprised 19 patients in whom free fibula flap was performed for upper and lower limb reconstruction, using SPSS 16. Results showed that flap survival was 100%. One (5.2%) flap was re-explored for venous congestion and was salvaged. One (5.2%) patient of congenital pseudoarthrosis of tibia had a fracture of the fibula and was treated with external fixation. Average follow up was 8 months...
December 2013: JPMA. the Journal of the Pakistan Medical Association
C Vlad, T S Gavriliu, I Georgescu, D Dan, A Parvan, Gh Burnei
No abstract text is available yet for this article.
September 15, 2013: Journal of Medicine and Life
R Gouron, F Deroussen, M-C Plancq, L-M Collet
INTRODUCTION: In pediatrics, Masquelet's induced membrane reconstructive technique has mainly been used in the context of cancer surgery reconstruction or congenital pseudarthrosis of the tibia. This retrospective study consisted of a series of pediatric patients where bone defects were reconstructed with this technique. MATERIALS AND METHODS: Between 2006 and 2011, 14 children underwent bone reconstruction using this technique in the context of trauma, tumor resection or congenital pseudarthrosis...
November 2013: Orthopaedics & Traumatology, Surgery & Research: OTSR
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