The surgical outcome among children with congenital pseudoarthrosis of Tibia: Our 12 years of experience

Background Congenital Pseudoarthrosis of the Tibia (CPT) is a rare condition characterized by poorly perfused, invasive hamartomatous fibrous tissue that leads to fracture and pseudoarthrosis of the tibia. Management challenges include achieving union and preventing refractures. This study aims to evaluate surgical interventions and their outcomes in managing congenital pseudoarthrosis of the tibia in children. Materials and methods This retrospective study reviewed 70 CPT cases treated between 2010 and 2022 at Nepal’s only specialized center for children with physical disabilities. It assessed demographics, surgical procedures, and outcomes, with techniques including periosteal grafting and the Masquelet method. Union was defined radiologically, and analyses were conducted using MS Excel and SPSS. Results This study included 70 CPT patients; 40 male (57.1%) and 30 female (42.9%). The mean age at presentation was 3.84 years, with the first surgery at 5.38 years. Most cases were Boyd type 5 (71.43%) and Crawford type 4 (71.43%). Of 35 patients who underwent surgery, the union rate was 41.93% (13/31), with a refracture rate of 23.08% among unions. Periosteal grafting had a 50% union rate, while the Masquelet technique achieved 41.67%. Conclusions This study highlights the challenges in managing Congenital Pseudoarthrosis of the Tibia (CPT), emphasizing the need for personalized surgical approaches based on patient age, limb length discrepancy, and classification. Effective patient counseling on risks and benefits is crucial for informed decisions.