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Femoral overgrowth in children with congenital pseudarthrosis of the Tibia

Cited 5 time in Web of Science Cited 5 time in Scopus
Authors
Song, Mi Hyun; Park, Moon Seok; Yoo, Won Joon; Cho, Tae-Joon; Choi, In Ho
Issue Date
2016-07-12
Publisher
BioMed Central
Citation
BMC Musculoskeletal Disorders, 17(1):274
Keywords
Congenital pseudarthrosis of the tibiaFemoral overgrowthDistraction osteogenesisNeurofibromatosis
Description
This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made.
Abstract
Abstract

Background
Having observed a tendency towards femoral overgrowth (FO) of the affected limb in children with atrophic-type congenital pseudarthrosis of the tibia (CPT), we aimed to identify the incidence of, contributors to, and patterns of FO among such children.


Methods
We retrospectively evaluated 55 children with CPT, 22 with prepseudarthrosis and 33 with atrophic-type CPT from 1989 to 2012. FO was defined as an affected femoral segment ≥10 mm longer than the contralateral segment. We investigated FO incidences in prepseudarthrosis versus atrophic-type CPT. Sex, laterality, coexistence of neurofibromatosis type 1, development of frank pseudarthrosis, extent of tibial shortening, shortening in foot height, deformity severity, distraction osteogenesis (DO) treatment, refracture, increased femoral neck-shaft angle, tibiofemoral angle, and ankle valgus angle were investigated to identify potential contributors to FO. Patterns of FO were also determined.


Results
At initial presentation, 11 patients exhibited a mean of 13 mm (10–23) of FO. However, the nature of FO changed over time during the follow-up period (mean, 10.8 years; range, 4.3–19.3). At the last follow-up, 14 patients presented with a mean of 12 mm (10–18) of FO. With the exception of one patient, all patients with FO presented with atrophic-type CPT. Frank pseudarthrosis, DO treatment, and increased femoral neck-shaft angle were significantly associated with FO (p = 0.016, p = 0.001, and p = 0.005, respectively). Diverse patterns of FO were observed.


Conclusions
FO of the affected limb is frequently encountered in patients with atrophic-type CPT. A compensatory response to frank pseudarthrosis, DO treatment, and neurofibromatosis may play a role in the diverse patterns of FO.
Language
English
URI
http://hdl.handle.net/10371/100651
DOI
https://doi.org/10.1186/s12891-016-1157-x
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College of Medicine/School of Medicine (의과대학/대학원)Orthopedic Surgery (정형외과학전공)Journal Papers (저널논문_정형외과학전공)
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