Relationship of postoperative complications and fibula integrity in congenital pseudarthrosis of the tibia in children

Objective To explore the relationship of postoperative complications and fibula integrity in congenital pseudarthrosis of the tibia (CPT) in children. Methods A retrospective study was conducted for examining the relationship of postoperative complications and fibula integrity with CPT in children.Between 2007 and 2011, 59 surgical patients with Crawford Ⅳ CPT were divided into 2 groups of CPT with fibular pseudarthrosis (group A) and CPT with fibula intact group (group B) according to fibula status after primary tibial union.The inter-group incidence was compared for re-fracture, ankle valgus, tibial valgus and limb length discrepancy. Results In group A, 14 (36.8%) cases had re-fracture.Among 30(78.9%) cases, the grade of ankle valgus was 0 (n=8), Ⅰ(n=15), Ⅱ(n=3) and Ⅲ (n=12). And 27(71%) cases of tibial valgus had an average angle of 7 ° (5°-20 °); 24 (63.2%) cases of limb length discrepancy had an average limb length of 1.26 (0.6-4.4) cm.In group B, 2 (9.5%) cases had re-fracture, 11 (52.4%) cases of ankle valgus had the grades of 0 (n=10), Ⅰ(n=6), Ⅱ(n=3) and Ⅲ (n=2); 8(42.9%) cases of tibial valgus had an average angle of 2.9° (5° -13°); 13 (61.9%) cases of limb length discrepancy had an average limb length of 1.48 cm (0.5-5). Significant inter-group differences existed in refracture and ankle valgus (P<0.05). Conclusions After primary union of CPT, fibular pseudarthrosis has a higher incidence of re-fracture and ankle valgus. Key words: Pseudarthrosis of the tibia, congenital; Pseudarthrosis; Postoperative complications; Fibula