Assessment of the clinical outcome of IM rod fixation in the treatment of tibial congenital pseudoarthrosis

  Abstract   Background: Pseudoarthrosis of the tibia poses one of the most challenging treatment   problems in all of orthopedics. The goal of the study was to assess the clinical   outcome of intramedullary rod fixation in its treatment.   Methods: The results of the management for nine patients with pseudoarthrosis of   the tibia with IM rod fixation were reviewed retrospectively between 1986 - 2006.   The mean duration of follow up was 8.95 years (range, 3.5 months to 14.2 years). The   mean age of the patients at the latest follow up was 13.5 years (range, 9 to 23 years).   Results: Initial :::union::: of the fracture site occurred in seven of nine patients with   the mean duration of 7.6 months (range, 3.5 to 15.5 months). Five patients had limb   length discrepancy with the mean of 7.2 cm (range, 1.5 - 12 cm). Three of them were   treated with tibia lengthening procedure with the Ilizarov method. One had a peroneal   nerve palsy postoperatively. Two patients had refracture treated with casting   and rod exchange. Electrical stimulation was applied in two patients but it was impossible to predict how much it played a role in the :::union:::.   Conclusion: IM rod fixation technique has a satisfactory functional outcome. The   technique has a high level of acceptance by parents and patients. It should be recommended   as the treatment of choice for the management of congenital pseudoarthrosis   of the tibia.