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Erschienen in: Journal of Children's Orthopaedics 6/2013

01.12.2013 | Original Clinical Article

Induced membrane technique for the treatment of congenital pseudarthrosis of the tibia: preliminary results of five cases

verfasst von: Stéphanie Pannier, Zagorka Pejin, Caroline Dana, Alain Charles Masquelet, Christophe Glorion

Erschienen in: Journal of Children's Orthopaedics | Ausgabe 6/2013

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Abstract

Purpose

The purpose of this study was to evaluate the two-stage surgical technique combining induced membrane, spongy autograft and intramedullary fixation for the treatment of congenital pseudarthrosis of the tibia (CPT).

Methods

Three boys and two girls were treated by this technique between 2003 and 2008. All patients had type IV CPT in Crawford’s classification. Four of them had a limited dystrophic form, whereas one case presented an extensive tibia bone dystrophy. The average age of patients at the time of surgery was 23 months (range 10–30 months), with an average follow-up of 5.8 years (range 2.4–8.1 years).

Results

Satisfactory tibial bony union was achieved in all cases at the last follow-up. Bone healing was obtained in the four limited forms after an average term of 4 months. One patient suffered from a non-displaced fracture that healed by casting in a usual period of time. The patient with an extensive dystrophic bone had to undergo a secondary inter-tibiofibular bone graft to finally achieve bone union.

Conclusions

The preliminary results show that this technique is successful in CPT. It may be used even in young children and offers a good alternative to other treatments available, avoiding external fixation and the technical difficulties of microvascular surgery.
Literatur
1.
Zurück zum Zitat Lehman WB, Atar D, Feldman DS, Gordon JC, Grant AD (2000) Congenital pseudoarthrosis of the tibia. J Pediatr Orthop B 9:103–107CrossRef Lehman WB, Atar D, Feldman DS, Gordon JC, Grant AD (2000) Congenital pseudoarthrosis of the tibia. J Pediatr Orthop B 9:103–107CrossRef
2.
Zurück zum Zitat Masquelet AC, Begue T (2010) The concept of induced membrane for reconstruction of long bone defects. Orthop Clin North Am 41:27–37CrossRef Masquelet AC, Begue T (2010) The concept of induced membrane for reconstruction of long bone defects. Orthop Clin North Am 41:27–37CrossRef
3.
Zurück zum Zitat Pannier S, Bourgeois A, Topouchian V, Pouliquen J-C, Finidori G, Glorion C (2007) Membrane induite et greffe spongieuse dans le traitement de la pseudarthrose congénitale de jambe chez l’enfant: résultats préliminaires à propos de 3 cas. Rev Chir Orthop Reparatrice Appar Mot 93:106CrossRef Pannier S, Bourgeois A, Topouchian V, Pouliquen J-C, Finidori G, Glorion C (2007) Membrane induite et greffe spongieuse dans le traitement de la pseudarthrose congénitale de jambe chez l’enfant: résultats préliminaires à propos de 3 cas. Rev Chir Orthop Reparatrice Appar Mot 93:106CrossRef
4.
Zurück zum Zitat Gouron R, Deroussen F, Juvet M, Ursu C, Plancq MC, Collet LM (2011) Early resection of congenital pseudarthrosis of the tibia and successful reconstruction using the Masquelet technique. J Bone Joint Surg Br 93:552–554CrossRef Gouron R, Deroussen F, Juvet M, Ursu C, Plancq MC, Collet LM (2011) Early resection of congenital pseudarthrosis of the tibia and successful reconstruction using the Masquelet technique. J Bone Joint Surg Br 93:552–554CrossRef
5.
Zurück zum Zitat Thabet AM, Paley D, Kocaoglu M, Eralp L, Herzenberg JE, Ergin ON (2008) Periosteal grafting for congenital pseudarthrosis of the tibia: a preliminary report. Clin Orthop Relat Res 466:2981–2994CrossRef Thabet AM, Paley D, Kocaoglu M, Eralp L, Herzenberg JE, Ergin ON (2008) Periosteal grafting for congenital pseudarthrosis of the tibia: a preliminary report. Clin Orthop Relat Res 466:2981–2994CrossRef
6.
Zurück zum Zitat Crawford AH (1978) Neurofibromatosis in the pediatric patient. Orthop Clin North Am 9:11–23 Crawford AH (1978) Neurofibromatosis in the pediatric patient. Orthop Clin North Am 9:11–23
7.
Zurück zum Zitat Johnston CE 2nd (2002) Congenital pseudarthrosis of the tibia: results of technical variations in the Charnley–Williams procedure. J Bone Joint Surg Am 84:1799–1810 Johnston CE 2nd (2002) Congenital pseudarthrosis of the tibia: results of technical variations in the Charnley–Williams procedure. J Bone Joint Surg Am 84:1799–1810
8.
Zurück zum Zitat Gilbert A, Brockman R (1995) Congenital pseudarthrosis of the tibia. Long-term followup of 29 cases treated by microvascular bone transfer. Clin Orthop Relat Res 314:37–44 Gilbert A, Brockman R (1995) Congenital pseudarthrosis of the tibia. Long-term followup of 29 cases treated by microvascular bone transfer. Clin Orthop Relat Res 314:37–44
9.
Zurück zum Zitat Sakamoto A, Yoshida T, Uchida Y, Kojima T, Kubota H, Iwamoto Y (2008) Long-term follow-up on the use of vascularized fibular graft for the treatment of congenital pseudarthrosis of the tibia. J Orthop Surg Res 3:13CrossRef Sakamoto A, Yoshida T, Uchida Y, Kojima T, Kubota H, Iwamoto Y (2008) Long-term follow-up on the use of vascularized fibular graft for the treatment of congenital pseudarthrosis of the tibia. J Orthop Surg Res 3:13CrossRef
10.
Zurück zum Zitat Grill F, Bollini G, Dungl P, Fixsen J, Hefti F, Ippolito E, Romanus B, Tudisco C, Wientroub S (2000) Treatment approaches for congenital pseudarthrosis of tibia: results of the EPOS multicenter study. European Paediatric Orthopaedic Society (EPOS). J Pediatr Orthop B 9:75–89CrossRef Grill F, Bollini G, Dungl P, Fixsen J, Hefti F, Ippolito E, Romanus B, Tudisco C, Wientroub S (2000) Treatment approaches for congenital pseudarthrosis of tibia: results of the EPOS multicenter study. European Paediatric Orthopaedic Society (EPOS). J Pediatr Orthop B 9:75–89CrossRef
11.
Zurück zum Zitat Paley D, Catagni M, Argnani F, Prevot J, Bell D, Armstrong P (1992) Treatment of congenital pseudoarthrosis of the tibia using the Ilizarov technique. Clin Orthop Relat Res 280:81–93 Paley D, Catagni M, Argnani F, Prevot J, Bell D, Armstrong P (1992) Treatment of congenital pseudoarthrosis of the tibia using the Ilizarov technique. Clin Orthop Relat Res 280:81–93
12.
Zurück zum Zitat Weiland AJ, Weiss AP, Moore JR, Tolo VT (1990) Vascularized fibular grafts in the treatment of congenital pseudarthrosis of the tibia. J Bone Joint Surg Am 72:654–662 Weiland AJ, Weiss AP, Moore JR, Tolo VT (1990) Vascularized fibular grafts in the treatment of congenital pseudarthrosis of the tibia. J Bone Joint Surg Am 72:654–662
13.
Zurück zum Zitat Cho TJ, Choi IH, Lee SM, Chung CY, Yoo WJ, Lee DY, Lee JW (2008) Refracture after Ilizarov osteosynthesis in atrophic-type congenital pseudarthrosis of the tibia. J Bone Joint Surg Br 90:488–493CrossRef Cho TJ, Choi IH, Lee SM, Chung CY, Yoo WJ, Lee DY, Lee JW (2008) Refracture after Ilizarov osteosynthesis in atrophic-type congenital pseudarthrosis of the tibia. J Bone Joint Surg Br 90:488–493CrossRef
14.
Zurück zum Zitat Kristiansen LP, Steen H, Terjesen T (2003) Residual challenges after healing of congenital pseudarthrosis in the tibia. Clin Orthop Relat Res 414:228–237CrossRef Kristiansen LP, Steen H, Terjesen T (2003) Residual challenges after healing of congenital pseudarthrosis in the tibia. Clin Orthop Relat Res 414:228–237CrossRef
15.
Zurück zum Zitat Mathieu L, Vialle R, Thevenin-Lemoine C, Mary P, Damsin JP (2008) Association of Ilizarov’s technique and intramedullary rodding in the treatment of congenital pseudarthrosis of the tibia. J Child Orthop 2:449–455CrossRef Mathieu L, Vialle R, Thevenin-Lemoine C, Mary P, Damsin JP (2008) Association of Ilizarov’s technique and intramedullary rodding in the treatment of congenital pseudarthrosis of the tibia. J Child Orthop 2:449–455CrossRef
16.
Zurück zum Zitat Kim HW, Weinstein SL (2002) Intramedullary fixation and bone grafting for congenital pseudarthrosis of the tibia. Clin Orthop Relat Res 405:250–257CrossRef Kim HW, Weinstein SL (2002) Intramedullary fixation and bone grafting for congenital pseudarthrosis of the tibia. Clin Orthop Relat Res 405:250–257CrossRef
17.
Zurück zum Zitat Ohnishi I, Sato W, Matsuyama J, Yajima H, Haga N, Kamegaya M, Minami A, Sato M, Yoshino S, Oki T, Nakamura K (2005) Treatment of congenital pseudarthrosis of the tibia: a multicenter study in Japan. J Pediatr Orthop 25:219–224CrossRef Ohnishi I, Sato W, Matsuyama J, Yajima H, Haga N, Kamegaya M, Minami A, Sato M, Yoshino S, Oki T, Nakamura K (2005) Treatment of congenital pseudarthrosis of the tibia: a multicenter study in Japan. J Pediatr Orthop 25:219–224CrossRef
18.
Zurück zum Zitat Wientroub S, Grill F (2000) Congenital pseudarthrosis of the tibia: Part 1. European Pediatric Orthopaedic Society multicenter study of congenital pseudoarthrosis. J Pediatr Orthop B 9:1–2CrossRef Wientroub S, Grill F (2000) Congenital pseudarthrosis of the tibia: Part 1. European Pediatric Orthopaedic Society multicenter study of congenital pseudoarthrosis. J Pediatr Orthop B 9:1–2CrossRef
19.
Zurück zum Zitat Joseph B, Somaraju VV, Shetty SK (2003) Management of congenital pseudarthrosis of the tibia in children under 3 years of age: effect of early surgery on union of the pseudarthrosis and growth of the limb. J Pediatr Orthop 23:740–746CrossRef Joseph B, Somaraju VV, Shetty SK (2003) Management of congenital pseudarthrosis of the tibia in children under 3 years of age: effect of early surgery on union of the pseudarthrosis and growth of the limb. J Pediatr Orthop 23:740–746CrossRef
20.
Zurück zum Zitat Choi IH, Lee SJ, Moon HJ, Cho TJ, Yoo WJ, Chung CY, Park MS (2011) “4-in-1 osteosynthesis” for atrophic-type congenital pseudarthrosis of the tibia. J Pediatr Orthop 31:697–704CrossRef Choi IH, Lee SJ, Moon HJ, Cho TJ, Yoo WJ, Chung CY, Park MS (2011) “4-in-1 osteosynthesis” for atrophic-type congenital pseudarthrosis of the tibia. J Pediatr Orthop 31:697–704CrossRef
21.
Zurück zum Zitat Dobbs MB, Rich MM, Gordon JE, Szymanski DA, Schoenecker PL (2004) Use of an intramedullary rod for treatment of congenital pseudarthrosis of the tibia. A long-term follow-up study. J Bone Joint Surg Am 86-A:1186–1197 Dobbs MB, Rich MM, Gordon JE, Szymanski DA, Schoenecker PL (2004) Use of an intramedullary rod for treatment of congenital pseudarthrosis of the tibia. A long-term follow-up study. J Bone Joint Surg Am 86-A:1186–1197
22.
Zurück zum Zitat Mahnken AH, Staatz G, Hermanns B, Gunther RW, Weber M (2001) Congenital pseudarthrosis of the tibia in pediatric patients: MR imaging. AJR Am J Roentgenol 177:1025–1029CrossRef Mahnken AH, Staatz G, Hermanns B, Gunther RW, Weber M (2001) Congenital pseudarthrosis of the tibia in pediatric patients: MR imaging. AJR Am J Roentgenol 177:1025–1029CrossRef
23.
Zurück zum Zitat Hermanns-Sachweh B, Senderek J, Alfer J, Klosterhalfen B, Büttner R, Füzesi L, Weber M (2005) Vascular changes in the periosteum of congenital pseudarthrosis of the tibia. Pathol Res Pract 201:305–312CrossRef Hermanns-Sachweh B, Senderek J, Alfer J, Klosterhalfen B, Büttner R, Füzesi L, Weber M (2005) Vascular changes in the periosteum of congenital pseudarthrosis of the tibia. Pathol Res Pract 201:305–312CrossRef
24.
Zurück zum Zitat El-Rosasy MA, Paley D, Herzenberg JE (2007) Congenital pseudarthrosis of the tibia. In: Rozbruch SR, Ilizarov S (eds) Limb lengthening and reconstruction surgery. Informa Healthcare, New York, pp 485–493 El-Rosasy MA, Paley D, Herzenberg JE (2007) Congenital pseudarthrosis of the tibia. In: Rozbruch SR, Ilizarov S (eds) Limb lengthening and reconstruction surgery. Informa Healthcare, New York, pp 485–493
25.
Zurück zum Zitat Viateau V, Guillemin G, Calando Y, Logeart D, Oudina K, Sedel L, Hannouche D, Bousson V, Petite H (2006) Induction of a barrier membrane to facilitate reconstruction of massive segmental diaphyseal bone defects: an ovine model. Vet Surg 35:445–452CrossRef Viateau V, Guillemin G, Calando Y, Logeart D, Oudina K, Sedel L, Hannouche D, Bousson V, Petite H (2006) Induction of a barrier membrane to facilitate reconstruction of massive segmental diaphyseal bone defects: an ovine model. Vet Surg 35:445–452CrossRef
26.
Zurück zum Zitat Pelissier P, Masquelet AC, Bareille R, Pelissier SM, Amedee J (2004) Induced membranes secrete growth factors including vascular and osteoinductive factors and could stimulate bone regeneration. J Orthop Res 22:73–79CrossRef Pelissier P, Masquelet AC, Bareille R, Pelissier SM, Amedee J (2004) Induced membranes secrete growth factors including vascular and osteoinductive factors and could stimulate bone regeneration. J Orthop Res 22:73–79CrossRef
27.
Zurück zum Zitat Masquelet AC, Fitoussi F, Begue T, Muller GP (2000) Reconstruction des os longs par membrane induite et autogreffe spongieuse. Ann Chir Plast Esthet 45:346–353 Masquelet AC, Fitoussi F, Begue T, Muller GP (2000) Reconstruction des os longs par membrane induite et autogreffe spongieuse. Ann Chir Plast Esthet 45:346–353
28.
Zurück zum Zitat Biau DJ, Pannier S, Masquelet AC, Glorion C (2009) Case report: reconstruction of a 16-cm diaphyseal defect after Ewing’s resection in a child. Clin Orthop Relat Res 467:572–577CrossRef Biau DJ, Pannier S, Masquelet AC, Glorion C (2009) Case report: reconstruction of a 16-cm diaphyseal defect after Ewing’s resection in a child. Clin Orthop Relat Res 467:572–577CrossRef
Metadaten
Titel
Induced membrane technique for the treatment of congenital pseudarthrosis of the tibia: preliminary results of five cases
verfasst von
Stéphanie Pannier
Zagorka Pejin
Caroline Dana
Alain Charles Masquelet
Christophe Glorion
Publikationsdatum
01.12.2013
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Children's Orthopaedics / Ausgabe 6/2013
Print ISSN: 1863-2521
Elektronische ISSN: 1863-2548
DOI
https://doi.org/10.1007/s11832-013-0535-2

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