Reconstruction of congenital pseudarthrosis of the radius with a vascularized tibial periosteal transplant: A case report

Author:

da Costa Antonio Carlos1,Farina Brunelli Joao Pedro1ORCID,Rojas‐Neira Juliana2,Falcochio Diego Figueira1,Sevilla‐Tirado Juan3,Soldado Francisco4ORCID

Affiliation:

1. Orthopaedic and Traumatology Surgery Department‐Santa Casa de Sao Paulo Hand Surgery and microsurgery Group Sao Paulo Brazil

2. Hand Surgery and Microsurgery Department Pontificia Javeriana University Cali Colombia

3. Orthopedic Surgery Department General Hospital of Defense Zaragoza Zaragoza Spain

4. Pediatric Hand Surgery and Microsurgery Barcelona Children's Hospital, HM Nens, HM Hospitales Sao Paulo Brazil

Abstract

AbstractCongenital pseudarthrosis of the forearm poses a considerable challenge because of its rarity. The objective of this report is to introduce a novel surgical technique for its treatment. Here, we document a case of congenital pseudarthrosis of the radius in a 3‐year‐old boy diagnosed with type‐1 neurofibromatosis. The surgical treatment involved the excision of approximately 9 cm of native radial periosteum and a bifocal radius osteotomy, which was supplemented with a vascularized tibial periosteal transplant to facilitate bone healing. Anastomosis between the anterior tibial vessels and radial vessels was performed. No immediate or late postoperative complications were observed. After 3 weeks, a robust callus formation was observed, and during a follow‐up examination 3 years and 4 months later, a wide range of active forearm rotation was noted. This report suggests that vascularized periosteal flaps show promise as a viable treatment option for congenital pseudarthrosis of the forearm. They offer an alternative to vascularized fibular grafts or single‐bone forearm constructs.

Publisher

Wiley

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