Congenital Pseudarthrosis of the Tibia Approach


Congenital Pseudarthrosis of the tibia (CPT) is a rare disorder in which a child is born with a specific bowing of the tibia (anterolateral) and/or a break of the tibia at birth. I firmly believe that every limb with this disorder can be treated, healed and not re-fracture by utilizing a Cross Union Technique. As a result, this condition should never undergo amputation.  During the over twenty years I have been in practice, I have seen this condition evolve from one with a nearly 30-40% amputation rate to now where amputation should be a never occurrence.

Utilizing pre-surgical Zolendronic Acid intravenously, combined with a surgery that includes: excising all the tissue causing the non-healing bone, freshening the bone edges, placing a very large bone graft from the patient’s pelvis (a unique and difficult procedure) between the tibia and fibula, utilizing Bone Morphogenic protein, a periosteal graft from the pelvic lining combined with a growing rod in the bone and a plate to hold it for 6 months. All of this has allowed for complete healing of the tibia in this population. The surgery also allows the ankle to move and preserves the ankle function.

David S. Feldman, MD
901 45th Street, Kimmel Building
West Palm Beach, FL 33407
Phone: 561-264-2141
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