Assessment of the clinical outcome of IM rod fixation in the treatment of tibial congenital pseudoarthrosis

Pseudoarthrosis of the tibia poses one of the most challenging treatment problems in all of orthopedics. The goal of the study was to assess the clinical outcome of intramedullary rod fixation in its treatment. The results of the management for nine patients with pseudoarthrosis of the tibia with IM rod fixation were reviewed retrospectively between 1986 - 2006. The mean duration of follow up was 8. 95 years (range، 3. 5 months to 14. 2 years). The mean age of the patients at the latest follow up was 13. 5 years (range، 9 to 23 years). Initial union of the fracture site occurred in seven of nine patients with the mean duration of 7. 6 months (range، 3. 5 to 15. 5 months). Five patients had limb length discrepancy with the mean of 7. 2 cm (range، 1. 5 - 12 cm). Three of them were treated with tibia lengthening procedure with the Ilizarov method. One had a peroneal nerve palsy postoperatively. Two patients had refracture treated with casting and rod exchange. Electrical stimulation was applied in two patients but it was impossible to predict how much it played a role in the union. IM rod fixation technique has a satisfactory functional outcome. The technique has a high level of acceptance by parents and patients. It should be recommended as the treatment of choice for the management of congenital pseudoarthrosis of the tibia.