Congenital pseudarthrosis of lower leg treated by almost outdated method: Case report
| Autor: | Igor Seslija, Zorica Zivkovic, Ismet Gavrankapetanović, Dusko Spasovski, Zoran Vukasinovic, Elvir Bazdar |
|---|---|
| Jazyk: | srbština |
| Rok vydání: | 2014 |
| Předmět: |
Male
Osteoplasty medicine.medical_specialty medicine.medical_treatment lcsh:Medicine 030204 cardiovascular system & hematology congenital pseudarthrosis of tibia law.invention Intramedullary rod 03 medical and health sciences 0302 clinical medicine law intramedullary fixation Deformity medicine Humans Tibia Fibula homologous graft Leg Bone Transplantation business.industry lcsh:R General Medicine homologousgraft Plastic Surgery Procedures medicine.disease 3. Good health Surgery Fracture Fixation Intramedullary Pseudarthrosis Amputation 030220 oncology & carcinogenesis Child Preschool medicine.symptom business Range of motion |
| Zdroj: | Srpski arhiv za celokupno lekarstvo (2014) 142(1-2):89-93 Srpski Arhiv za Celokupno Lekarstvo, Vol 142, Iss 1-2, Pp 89-93 (2014) |
| ISSN: | 0370-8179 |
| Popis: | 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. Early conservative treatment was unsuccessful, so child never initiated gait. At the age of three and a half years, operative treatment was applied: resection of pseudarthrosis on both tibia and fibula, and osteoplasty of tibia using cylindric homologous graft and intramedullary fixation with transtarsal Steinman pin, followed by long leg cast immobilization. Pin was removed after ten months, and physical therapy was initiated 1.5 year after surgery, with initial to partial weight bearing and short leg cast throughout another year. Two and a half years after surgery complete union of graft was documented, and then full weight bearing was allowed. At final visit, five years and three months after surgery, shin axis was correct, leg lengths were equal, and child had normal walk with full range of motion. X-ray showed complete union of both tibia and fibula. Conclusion. Despite bad prognostic factors (young age, severe deformity), utilization of obsolete and almost forgotten treatment methods can provide excellent result. [Projekat Ministarstva nauke Republike Srbije, br. III 41004] |
| Databáze: | OpenAIRE |
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