Jahmani Rami, Alorjani Mohammed
Department of Special Surgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Department of Pathology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Am J Case Rep. 2018 Apr 11;19:426-430. doi: 10.12659/ajcr.908482.
BACKGROUND Congenital pseudoarthrosis of the tibia is one of the most difficult orthopedic diseases to treat. Many authors consider osteotomy of the bowed non-broken tibia a contraindication. However, leaving the patient with a deformed, bowed leg is intolerable and is associated with deformity progression and increased risk of fracture. CASE REPORT A 12-year-old boy presented with a bowed leg. X-ray tibia showed partially healed congenital pseudoarthrosis of the tibia and 30 degrees of flexion deformity. Deformity was successfully treated by percutaneous osteotomy made through the site of congenital pseudoarthrosis and gradual correction using a computer-assisted external fixator, the Taylor spatial frame (TSF; Smith and Nephew, Memphis, TN). At the end of the correction, a telescopic Fassier-Duval intramedullary nail was used prophylactically to prevent re-fracture. After 2 years of follow-up, X-ray images show bone-healing without any bowing. CONCLUSIONS Closed percutaneous osteotomy, without excision of the pseudoarthrosis, and gradual correction then insertion of Fassier-Duval telescopic nail may serve as a treatment to correct deformed bone in congenital pseudoarthrosis of the tibia.
先天性胫骨假关节是最难治疗的骨科疾病之一。许多作者认为对弯曲但未折断的胫骨进行截骨术是一种禁忌。然而，让患者留下畸形、弯曲的腿是无法忍受的，并且会导致畸形进展和骨折风险增加。病例报告：一名12岁男孩出现腿部弯曲。胫骨X线显示先天性胫骨假关节部分愈合以及30度的屈曲畸形。通过经先天性假关节部位进行经皮截骨术，并使用计算机辅助外固定器——泰勒空间框架（TSF；史赛克公司，田纳西州孟菲斯）进行逐步矫正，成功治疗了畸形。在矫正结束时，预防性使用伸缩式法西耶 - 杜瓦尔髓内钉以防止再次骨折。经过2年的随访，X线图像显示骨愈合且无任何弯曲。结论：不切除假关节的闭合经皮截骨术、逐步矫正然后插入法西耶 - 杜瓦尔伸缩钉，可作为治疗先天性胫骨假关节畸形骨的一种方法。
