Congenital Tibia Pseudarthrosis
Congenital Tibiapseudarthrosis is a very rare illness of the shinbone (tibia) which can occur in conjunction with the fibula (the bone behind the shinbone). In 50% of cases, there is a link with Neurofibromatosis (Recklinghausen-Syndrom) recognizable by the formation of cafe au lait spots on the skin. Through the deformation of the affected tubular bone, the formation of a „false joint“occurs (Pseudarthrosis) usually in the middle to lower third of the tibia. Usually the diagnosis is confirmed by x-rays which can show a significant thinning of the bones in the area of the Pseudarthrosis. In most cases, the Pseudarthrosis is very unstable and leads to deformation of the bone in the area of the lower leg, which makes it impossible to put any weight on the leg. Frequently, orthopaedic aids (braces) are needed to support the leg.

Classification
Crawford
Type I : Anterior bowing with increased cortical density
Type II : Anterior bowing with a failure of tubulation and narrowed, sclerotic medullary canal
Type III : Anterior bowing with a cystic lesion or pre fracture
Type IV : Anterior bowing with a frank fracture and pseudarthrosis, usually involving the tibia and fibula
Boyd
Type I : Anterior bowing and defect in the tibia at birth, associated with other congenital abnormalities
Type II : Anterior bowing and hour glass constriction of the tibia, spontaneous fracture by 2 years is the most frequent variety and is associated with neurofibromatosis. Recurrence is common
Type III : Pseudarthrosis develops through a congenital cyst
Type IV : Pseudarthrosis develops in a sclerotic segment of bone without narrowing, stress fracture
Type V : Pseudarthrosis of the tibia occurs with a dysplastic fibula, pseudarthrosis of one or both bones (prognosis similar to Type II)
Type VI : Pseudarthrosis occurs in association with an intra-osseous neurofibroma or schwannoma (rare)
Picutres of Pseudarthrosis of the Tibia
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