Treatment of an adult with neglected congenital pseudoarthrosis of the tibia with acute fracture: a case report.

Treatment of congenital pseudoarthrosis of the tibia is very difficult. Numerous surgical procedures have been used including bone grafting, fixation, pulsed electromagnetic field, vascularized fibular bone grafting and lengthening devices. Previous studies, often reporting unsatisfactory results, are limited to children and adolescents. In adults, the following factors need to be considered: leg length discrepancy, leg deformity, soft tissue problems, lack of potential for growth and difficulties in healing. We reported a case of untreated congenital pseudoarthrosis of the tibia with fracture in a 32-year-old man. Conventional treatments used included excision of the pseudoarthrosis, correction of the deformity, intramedullary fixation, bone grafting and soft tissue transplantation for lengthening and coverage. These procedures led to good bony union and a satisfactory outcome.