Presentation
True bone dysplasia with non union or potential non union through a hamartomatoUsually area in the tibia. not present at birth really a fibrous non-union of a pathological fracture The defect in the bone is filled with mature, fibrous connective tissue [orthofracs.com]
Reports described clinical presentation to range from simple anterolateral bowing of tibia to frank pseudarthrosis 3 .In this series 25 out of 37(60%) presented with established pseudarthrosis, while 10 out of 37(27%) presented with bowing. [sudjms.net]
Congenital pseudoarthrosis of the clavicle is a rare condition, which typically presents as an isolated anatomical variant. Clinical presentation Usually presents as a midclavicular swelling in the neonate or young child 1. [radiopaedia.org]
[…] if the condition was present at the time of inpatient admission. [icd.codes]
All patients presented signs of neurofibromatosis as café-au-lait stains and family history. Patients with CPF affecting only the radius presented deformity similar to congenital radial club hand. [meeting.handsurgery.org]
Entire Body System
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Chills
The history of the disease revealed that the child initially presented with fever and chills. He was then treated for malaria for a few days, as it is common in endemic areas. [dovepress.com]
Musculoskeletal
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Recurrent Fractures
However, surgical intervention is required in case of non-union and recurrent fractures. The surgical therapy consists of resection of the diseased segment and bone grafting, followed by internal or external fixation [ 3 ]. [e-aps.org]
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Long Legs
The Ilizarov fixator was then removed and replaced by a long-leg synthetic cast for an additional 6 weeks to prevent early fracture. The consolidation of the regenerate bone was achieved after 245 days. [dovepress.com]
The wound was closed in layers and a long leg splint was applied. Three months later, no abnormal changes were noted in X-ray imaging and no clinical wounds were observed ( Figs. 4, 5 ). [e-aps.org]
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Flexion Contracture
Early physiotherapy was prescribed, and the boy was monitored regularly to prevent a flexion contracture or stiff knee. [dovepress.com]
Skin
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Skin Lesion
Chromosome 17 is defective in NF1 and skin manifestation are prominent ,such sessile or pedunculated skin lesions (mollusca fibrosa) and café au lait spots Haemartomas,gliomas, and alignment nerve sheath tumor are also seen in NF1along with spiral [slideshare.net]
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Cutaneous Manifestation
manifestations of neurofibromatosis clarifies the diagnosis The late form of pseudoarthosis presents as fracture in an older child will probably be companied by of this findings x ray is the diagnostic tool 42. A dysplasia of the mesodermal and [slideshare.net]
Psychiatrical
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Withdrawn
They may become isolated and withdrawn because they feel different from others. They may have emotional and/or social pain concerning their appearance. They may experience fear of the complications and they may even wonder whether to have children. [orthoinfo.aaos.org]
Neurologic
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Walking Delay
As the child is not operated before he reaches a certain age, wearing a protective brace before the child has begun walking delays the fracture in bowing and limits the deformity if pseudarthrosis is already present. [boneandspine.com]
Treatment
This treatment avoids risking injury to the healthy contralateral leg. Additionally, for treatments that do not achieve satisfactory results, other treatment methods are not excluded. [journals.lww.com]
Intramedullary stabilization, free vascularized fibula, and Ilizarov external fixation are among the most frequently used methods of treatment. In addition, bone morphogenetic protein recently has shown promise. [experts.umich.edu]
[…] extremity at the completion of treatment It is essential to set realistic goals and to adhere to the treatment principles and technical details The treatment is multidisciplinary and multi modal 4 Aims Long term bony union without axial or rotational [slideplayer.com]
[…] gait analysis and muscle strength testing to determine the functional result of treatment. [utsouthwestern.influuent.utsystem.edu]
- patellar tendon bearing - total contact orthosis, which is used to try to prevent frxs or to control developing ones; - Surgical Treatment Options: - once frx ensues, treatment includes open reduction, internal fixation, & bone grafting w/ autogenous [wheelessonline.com]
Prognosis
Prognosis worse with Neurofibromatosis 1/2 of cases 3 Fracture develops at site of bone cyst Usually near junction of mid/ distal 1/3 Anterior bowing precedes or follow fracture 4 Sclerotic bony segment initially present at junction of mid/ distal 1/ [orthofracs.com]
The prognosis is good if the lesion is located only on the fibula, an extension to the tibia has a prognosis similar to type II, Type VI Associated with an intraosseous fibroma or a schwannoma. [boneandspine.com]
Type III cases have a better prognosis. The gross pathology is a bone cyst, and the microscopic findings resemble fibrous dysplasia. After surgical treatment, generally, the older the child the better the prognosis. [scienceopen.com]
The prognosis depends on the aggressiveness and treatment of the intraosseous lesion. [orthopedicnotes.blogspot.com]
ダンセイ, 偽関節, ギカンセツ, pseudarthrosis, 057781, *, 先天性疾患, センテンセイシッカン, congenital disease, 040292, 下腿, カタイ, crus, 052725, 血管付移植, ケッカンツキイショク, vascularized transplantation, 054802, 骨移植, コツイショク, bone transplantation, 054803, 腓骨, ヒコツ, fibula, 038596, 予後, ヨゴ, prognosis [togodb.dbcls.jp]
Etiology
Its etiology remains unclear. Although several classification systems have been proposed, none provides specific guidelines for management. Treatment remains challenging. The goal is to obtain and maintain union while minimizing deformity. [experts.umich.edu]
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Part I covers general principles and techniques, including etiology, clinical evaluation, imaging as well as different surgical methods. [books.google.com]
The etiology is unknown but an intrauterine pathogenesis is favored over non-union of birth trauma. Associations cleidocranial dysostosis trisomy 21 neurofibromatosis type 1 Promoted articles (advertising) [radiopaedia.org]
Epidemiology
Each chapter has a case presentation, series of clinical questions, and fundamentals on etiology and epidemiology, clinical evaluation, and surgical indications. [books.google.com]
Bowing usually at junction of Mid / Distal 1/3 Epidemiology Rare 1:200 000 M F 50% have Neurofibromatosis type 1 1-3% of Neurofibromatosis have CPT Aetiology Cause unknown Theories include: Intrauterine fracture Localised vascular abnormality Constriction [orthofracs.com]
Hefti F, Bollini G, Dungl P, Fixsen J, Grill F, Ippolito E, Romanus B, Tudisco C, Wientroub S (2000) Congenital pseudarthrosis of the tibia: history, etiology, classification, and epidemiologic data. [link.springer.com]
Epidemiology and treatment outcome of congenital pseudarthrosis of the tibia. J Child Orthop. 2013;7(2):157-66. 6. Beals RK, Fraser W. Familial congenital bowing of the tibia with pseudarthrosis and pectus excavatum: report of a kindred. [sudjms.net]
Congenital pseudarthrosis of the tibia: History, etiology, classification, and epidemiologic data. J Pediatr Orthop B. 2000;9:11– 5. Gutmann DH, Aylsworth A, Carey JC, Korf B, Marks J, Pyeritz RE, et al. [boneandspine.com]
Pathophysiology
Lower Limb Deformity in Neuromuscular Disorders: Pathophysiology, Assessment, Goals and Principles of Management.- Arthrogryposis.- Limb Lengthening and Deformity Correction in Patients with Skeletal Dysplasias.- Lower Extremity Benign Bone Lesions [searchworks.stanford.edu]
A relationship with type 1 neurofibromatosis or von Recklinghausen’s disease is known but exact pathophysiology has still not been clearly defined. [boneandspine.com]
Appropriate interpretation will improve understanding of the natural history and pathophysiology of neurofibromatosis type 1. [nature.com]
Levine, Fu-Chan Wei Anatomy and Pathophysiology; Robert M. Whitfield, Jeremy R. Rinard, Lee L. Q. Pu Evaluation and Management of Complex Traumatic Injuries; Allison M. Barrett, Ronald J. [euro-libris.ro]
Prevention
poor protection against re-fracture, failure to correct limb length discrepancy, and deformities of leg and ankle simultaneously at time of primary surgery. 8 Vascularized fibular graft/ Nail The intramedullary rod offers good tibial alignment and prevents [slideplayer.com]
An anti-foot drop device was applied immediately after surgery to prevent equinus deformity of the foot. Early physiotherapy was prescribed, and the boy was monitored regularly to prevent a flexion contracture or stiff knee. [dovepress.com]
Prevention There is no known way to prevent congenital amputations, but the prevention of birth defects in general begins with the well being of the mother before and during pregnancy. [encyclopedia.com]
Prevention Studies have suggested that a multivitamin including folic acid may reduce birth defects, including congenital abnormalities. [medical-dictionary.thefreedictionary.com]
an operation that prevents the ankle deformity without grafting in fibular pseudarthrosis is useful. [orthopedicnotes.blogspot.com]