# Congenital pseudarthrosis of the tibia Congenital pseudarthrosis of the tibia This rare condition presents with an anterolateral bow of the tibia with or without a fracture. Classic radiographic changes are noted and 50% are associated with neurofibromatosis. Once fractured the tibia is reluctant to heal. Long-term orthotic treatment may be necessary , with subsequent surgical procedures designed to obtain bony union and restore leg length ( Figure 44.28 ). Summary box 44.11 Abnormalities of the knee and lower leg /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF OCD – better prognosis in children than in adults Discoid meniscus – usually lateral, may require surgery Anterior knee pain – treatment usually conservative Fibular hemimelia – associated with abnormalities from the foot proximally (foot worse than hip); the tibial bow has an anteromedial apex Blount’s disease – clinically, a sharp proximal tibial angulation Congenital pseudarthrosis of the tibia – the tibial bow has an anterolateral apex Apex posteromedial tibial bow – the bow improves with time but the limb may be short Figure 44.28 Anteroposterior radiograph of a child showing a congenital tibial pseudarthrosis and abnormal /f_i bula. She was born with a bowed lower leg that subse - quently fractured. She has a family history of neuro /f_i bromatosis. Congenital pseudarthrosis of the tibia This rare condition presents with an anterolateral bow of the tibia with or without a fracture. Classic radiographic changes are noted and 50% are associated with neurofibromatosis. Once fractured the tibia is reluctant to heal. Long-term orthotic treatment may be necessary , with subsequent surgical procedures designed to obtain bony union and restore leg length ( Figure 44.28 ). Summary box 44.11 Abnormalities of the knee and lower leg /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF OCD – better prognosis in children than in adults Discoid meniscus – usually lateral, may require surgery Anterior knee pain – treatment usually conservative Fibular hemimelia – associated with abnormalities from the foot proximally (foot worse than hip); the tibial bow has an anteromedial apex Blount’s disease – clinically, a sharp proximal tibial angulation Congenital pseudarthrosis of the tibia – the tibial bow has an anterolateral apex Apex posteromedial tibial bow – the bow improves with time but the limb may be short Figure 44.28 Anteroposterior radiograph of a child showing a congenital tibial pseudarthrosis and abnormal /f_i bula. She was born with a bowed lower leg that subse - quently fractured. She has a family history of neuro /f_i bromatosis. Congenital pseudarthrosis of the tibia This rare condition presents with an anterolateral bow of the tibia with or without a fracture. Classic radiographic changes are noted and 50% are associated with neurofibromatosis. Once fractured the tibia is reluctant to heal. Long-term orthotic treatment may be necessary , with subsequent surgical procedures designed to obtain bony union and restore leg length ( Figure 44.28 ). Summary box 44.11 Abnormalities of the knee and lower leg /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF OCD – better prognosis in children than in adults Discoid meniscus – usually lateral, may require surgery Anterior knee pain – treatment usually conservative Fibular hemimelia – associated with abnormalities from the foot proximally (foot worse than hip); the tibial bow has an anteromedial apex Blount’s disease – clinically, a sharp proximal tibial angulation Congenital pseudarthrosis of the tibia – the tibial bow has an anterolateral apex Apex posteromedial tibial bow – the bow improves with time but the limb may be short Figure 44.28 Anteroposterior radiograph of a child showing a congenital tibial pseudarthrosis and abnormal /f_i bula. She was born with a bowed lower leg that subse - quently fractured. She has a family history of neuro /f_i bromatosis.