Long-Term Evaluation of Bone Healing and Functional Outcome Following Vascularized Fibular Grafting for Congenital Pseudoarthrosis of the Tibia in Pediatric Population

Abstract

Congenital pseudoarthrosis of the tibia presents a challenging treatment scenario. In a recent investigation, vascularized fibular grafting (VFG) was employed to address this condition in a cohort comprising five female and three male patients. The mean age of the recipients undergoing VFG was 7.1 years, ranging from 1.8 to 11.6 years, and the subsequent follow-up extended over an average of 11.8 years, with a range spanning from 4.8 to 19.7 years. Among the subjects, five individuals had previously undergone multiple surgical interventions, while the remaining three had not undergone any prior operations. Across all instances, successful bone consolidation was achieved within an average period of 6.7 months. In seven cases, this consolidation was achieved following the initial VFG procedure, whereas one case necessitated a second VFG for the consolidation. Notably, patients with a history of multiple prior operations exhibited a more significant discrepancy in leg length, averaging 7.6 cm, in contrast to those without prior surgical interventions, who displayed an average leg length difference of 0.8 cm. The results underscore VFG as a promising primary treatment approach for CPT, displaying favorable long-term outcomes, particularly in cases where prior surgical interventions had not been undertaken.