In this paper we report the follow-up of over ten years of three cases of congenital pseudoarthrosis of the tibia treated by steroid local infiltrations. In the past this method had been proposed by Scaglietti and Associates for simple bone cysts and not for congenital pseudoarthrosis of the tibia. Our procedure includes first percutaneous drilling of the bone to create small canals through which we inject the methylprednisolone acetate. The results obtained with this simple method are quite interesting for the absence of recurrence after a long follow-up (over 10 years) and the excellent bone reconstruction of the tibial defect in all three cases. Whatever treatment is applied (bone transplants, vascularized bone graft using microsurgical techniques, electromagnetic induction and application of external fixators), it should aim at eliminating the interposed fibrous tissue which causes congenital tibial pseudoarthrosis and the recurrence of fractures. The precise mechanism of steroids applied locally is still unclear. Probably, the steroid slows down fibrous tissue production and allows the development of solid bone or even determines metaplasia of fibrous tissue. After confirmation in a larger group of patients, this method could become an alternative treatment of congenital pseudoarthrosis of the tibia, especially at early ages, when other methods are not applicable or are too aggressive.
|Translated title of the contribution||Long term follow-up of local steroid treatment of congenital pseudoarthrosis of the tibia|
|Number of pages||7|
|Journal||Minerva Ortopedica e Traumatologica|
|Publication status||Published - 1996|
ASJC Scopus subject areas