Review Question - QID 6148

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Anterolateral Bowing & Congenital Pseudoarthrosis of Tibia QID: 6148 (SAE07PE.88)

QID 6148 (Type "6148" in App Search)

Figure 40 shows the radiographs of a 2-year-old boy who has a deformed leg. The patient is ambulatory and has no pain. What is the most appropriate management?

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Observation

53%

306/575

Patellar tendon bearing (PTB) orthosis

28%

163/575

Osteotomy to correct the deformity and fixation with an intramedullary rod

14%

82/575

Vascularized fibular graft from the contralateral leg

17/575

Amputation

1/575

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The patient has a prefractured stage of congenital pseudarthrosis of the tibia and is at risk for fracture. The PTB orthosis may prevent or delay the fracture. Osteotomy is frequently complicated by nonunion. When established nonunion does not respond to intramedullary nailing and bone grafting, vascularized grafting may succeed. Amputation is a salvage procedure.