Ganga Medical Centre & Hospitals Pvt Ltd

Coimbatore, India.

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Pseudarthrosis tibia

What is a pseudarthrosis?

It literally means 'false joint'. A pseudarthrosis is an area where the bone has broken and not united for long, leading to formation of a joint like cavity.

What is 'congenital pseudarthrosis of tibia' [CPT]?

Some children develop such false joints in the leg bone, due to an anomaly present from birth. Many forms of CPT are known, but they all cause problems as they do not unite with usual forms of treatment.

What are the treatment options?

A large number of treatment methods have been tried in CPT with varying success. At Ganga Hospital the preferred method is a Free Fibular Flap.

What is a Free Fibular Flap?

The thin bone of the leg is harvested along with its blood vessels. The bone is then used to fill the gap and the blood vessels are connected to local vessels.

How long does it take for the bones to unite?

The fibula unites in about 3 months from surgery. However, it may sometimes take longer due to multiple surgeries already having been performed and poor healing potential.

What is the role of Plastic Surgery?

The free fibular flap requires harvesting of the thin bone from the leg with its blood vessels. This bone piece is transferred to the gap and blood vessels connected under the microscope. Such surgery is performed by Plastic surgeons trained in Microsurgery.

What happens to the leg from which bone is taken?

The fibula is the thin bone in the leg and is not weight bearing in function. So taking it out does not cause any long term problems with walking. The ends of the bone near the knee and ankle joints are not taken to preserve joint stability.

Can free fibula be done even after multiple earlier operations?

Yes, it can usually be done. A final assessment can be made only on personally examining the child. But many children, having undergone many operations elsewhere, have been helped with this surgery.

Is such Microsurgery safe in children?

CPT affects children and affects them severely by curtailing mobility at a tender age. The surgery is therefore most needed in them. Microsurgery as such is not especially dangerous in children, but is technically tougher due to the small size of blood vessels.

Severely deformed leg of a girl afflicted by CPT. Free fibula flap has restored shape and ensured union.

Pre operative deformity


Intra operative with harvested free fibula


Post operative after wound healing and correction of deformity


Post operative xray









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