Treatment of Congenital Pseudarthrosis Tibia by Ilizarov Principle

Abstract

Background: Congenital pseudarthrosis of the tibia (CPT) presents significant treatment challenges due to its complex pathology and  high complication risk. The Ilizarov technique, based on the principles of distraction osteogenesis, offers a promising approach to  manage this condition.

Objective: To assess the effectiveness of Ilizarov technique in resecting congenital pseudarthrosis and  lengthening the tibia, with evaluations of union rates, mechanical axis deviation, range of motion in ankle and knee joints, and  complications.

Patients and Methods: In a prospective, retrospective cohort study at Benha University Hospitals, 30 patients with CPT  underwent treatment using the Ilizarov technique. Clinical and radiological evaluations were conducted to assess union, while mechanical  axis deviation and joint range of motion were measured.

Results: The mean age of the participants was 11.3 ± 3.65 years,  with a male predominance (60%). The Ilizarov technique, involving corticotomy and bone transport in 83.33% of patients, showed union in  93.33% of cases, with treatment duration averaging 9.9 ± 4.06 months. Radiological outcomes were rated as excellent in 20%, good in  46.67%, fair in 26.67%, and poor in 6.67% of patients. Complications included pin tract infections in all patients, pain in 13.33%, non-union  in 6.67%, refracture in 20%, ankle stiffness in 10%, and valgus deformity at the ankle in 16.67%. The final leg-length discrepancy was  corrected to a mean of 2.7 ± 1.04 cm.

Conclusion: The Ilizarov technique demonstrates a high efficacy in treating CPT, with significant  improvements in bone lengthening, union rates, and mechanical alignment.