ArticleJournal of children's orthopaedics2019
Congenital pseudarthrosis of the tibia: biological and biomechanical considerations to achieve union and prevent refracture.
Article in Journal of children's orthopaedics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05693558 (A Proof-of-concept Study With NVD-003, an Autologous Osteogenic Bone Graft, in the Treatment of Congenital Pseudarthrosis of the Tibia in Pediatric Patients.), which is not on this map. Cited by 45 papers.
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A Proof-of-concept Study With NVD-003, an Autologous Osteogenic Bone Graft, in the Treatment of Congenital Pseudarthrosis of the Tibia in Pediatric Patients.
Who cites it
45 citing papers in PubMed, 97 citations in OpenAlex.
- Multimodal Biological Augmentation with Umbilical Cord Mesenchymal Stem Cell Secretome, Recombinant Human Bone Morphogenetic Protein-2, and Allogeneic Umbilical Cord Mesenchymal Stem Cells in Neurofibromatosis Type 1-Confirmed Congenital Pseudarthrosis of the Distal Tibia and Fibula: A Case Report with Mechanistic Scoping Review.Journal of orthopaedic case reports · 2026Article
- Angular Improvement with Bracing Over 7 Years in Anterolateral Tibial Bowing without Neurofibromatosis Type 1: A Case Report.Journal of orthopaedic case reports · 2026Article
- Article
- Profile and Outcomes of Neurofibromatosis Type 1 (NF1) Patients in a Tertiary Government Hospital in the Philippines: A Retrospective Descriptive Study.Acta medica Philippina · 2026Article
- Congenital pseudarthrosis of the proximal tibia: a case report.Frontiers in pediatrics · 2026Article
- Extent of the low-density line is associated with time to fracture in children with congenital anterolateral bowing of the tibia: a retrospective survival analysis.Frontiers in pediatrics · 2026Article
- An Autologous Human Adipose Stem Cell-Derived 3D Osteogenic Implant for Bone Grafting: From Development to First-in-Human Experience.Journal of clinical medicine · 2025Article
- Combined surgery with intramedullary rod fixation across the ankle for the treatment of Crawford IV congenital pseudarthrosis of the tibia: a long-term follow-up study.Orphanet journal of rare diseases · 2025Article
- Coincidence of Congenital Pseudarthrosis of the Tibia and Hemihypertrophy in a Patient With Neurofibromatosis Type 1.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025Article
- Long-term Surgical Outcome of Congenital Pseudarthrosis of the Tibia.Malaysian orthopaedic journal · 2025Article
- Cable-asisted bone transport versus circular external fixators-asisted bone transport in the management of bone defects of the Tibia: clinical and imaging results.Journal of orthopaedic surgery and research · 2025Article
- Mother to Child Non-Vascularized Fibula Transfer in Congenital Pseudoarthrosis of Tibia.Journal of orthopaedic case reports · 2025Article
- Efficacy of the cross-union protocol in the treatment of congenital tibial pseudarthrosis: a comparative study.BMC musculoskeletal disorders · 2025Article
- Cross-union surgery for tibiofibular fractures in McCune-Albright syndrome: a case report and literature review.Frontiers in pediatrics · 2025Article
- [Clinical study of Cross-Union surgery for treatment of pseudarthrosis of tibia with neurofibromatosis type 1 in children].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2024Article
- Osteoperiosteal fibular strut grafting - A technique to improve union rates.International orthopaedics · 2024Article
- Ilizarov Distraction for Congenital Pseudoarthrosis of the Tibia in Adults.Orthopaedic surgery · 2024Article
- What's new in pediatric lower limb reconstruction?Journal of children's orthopaedics · 2024Article
- Congenital tibial pseudarthrosis: A challenge in pediatric radiology.Radiology case reports · 2024Article
- Preventing of nonunion in congenital pseudarthrosis of the tibia cases of Crawford Type I and II through the use of allograft bypass and a brace: Midterm findings.Journal of children's orthopaedics · 2024Article
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1 author.
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Abstract
Congenital pseudarthrosis of the tibia (CPT) is likely to be a primary periosteal disease and secondary bone disease. The primary goal of treatment is to obtain union, correct the diaphyseal deformity, correct any proximal fibular migration and prevent refracture. The pathobiology demonstrates increased osteoclasis by the surrounding fibrous hamartoma and reduced osteogenesis and bone morphogenic protein production by the bone. This leads to a loss of remodelling potential and gradual bowing and atrophy of the bone with eventual fracture of the tibia and or fibula. This recommends the synergistic use of bisphosphonates and bone morphogenic protein. The pathomechanics of CPT implicate the anterolateral bowing, narrow diameter of the atrophic bone ends and proximal fibular migration. These biomechanical factors can be addressed by means of straightening of the deformity, intramedullary support of both bones, stable fixation and reduction of proximal migration of the fibula. A summary of the literature on CPT shows that the mean probability of achieving primary union without refracture, by most treatments is 50% (12% to 80%). Two recent studies have shown a much higher success rate approaching 100%, by creating a cross-union between the tibia and fibula. The cross-union with intramedullary reinforcement of the bone makes refracture unlikely due to the cross-sectional area of union with its two-bar linkage. A new classification to guide such treatment is also proposed. LEVEL OF EVIDENCE: V - expert opinion.
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