Reconstruction of Congenital Pseudarthrosis of the Radius Using a Vascularized Tibial Periosteum Transplant: A Case Report
Abstract
Congenital pseudarthrosis of the radius is a rare condition, commonly associated with neurofibromatosis or fibrous dysplasia. We present the first reported case of using a vascularized periosteal flap for the treatment of congenital pseudarthrosis of the radius. The patient was a 14-month-old boy with neurofibromatosis type 1, presenting with severe shortening of the forearm, radial deviation of the wrist, and limitation of pronation-supination (60°-80°). Radiographs revealed pseudarthrosis in the distal third of the right radius. Surgical treatment involved debridement, bone fixation with a Kirschner wire, and placement of a vascularized periosteal flap harvested from the contralateral tibia to cover the pseudarthrosis site. Radiographic evidence of callus formation was observed two weeks postoperatively, accompanied by full wrist flexion-extension and improved pronation-supination (90°-90°). At five weeks, the patient resumed activities without orthotic protection. The use of vascularized tibial periosteum represents an innovative approach for treating congenital pseudarthrosis of the radius, demonstrating rapid bone healing and early return to activity, with no morbidity at the donor site.Downloads
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