Case Report: Congenital Tibiofibular Pseudoarthrosis

Tibiofibular pseudoarthrosis is considered a rare pathology, with a reported incidence of 1:190.000 in United Kingdom and 1:28.000 in Finland. Prenatal ultrasound may detect an abnormal tibial curvature, but final diagnosis is definitively postnatal. Aim: We present a case of congenital tibiofibular pseudoarthrosis in a healthy newborn.

Full-term, appropriate for gestational age, male newborn, given birth by elective c-section. In post- natal assessment, a congenital malformation was seen. It was described like a complete right tibial-fibular fracture, however, radiological studies showed tibiofibular pseudoarthrosis. At one year of age, surgical correction was made with Paley technique, providing autograft, allograft, Bone Morphogenic Proteins and external tutor. Four months later, external tutor was removed and replaced by an endomedullary nail, with good tolerance. Motor rehabilitation was started and because of an excellent outcome he was definitively discharged.

Congenital tibiofibular pseudoarthrosis, is usually described as a separate entity; nevertheless, this combined form, even rarer, also exists, and its prenatal diagnosis is even more difficult. This can be done by prenatal ultrasound, although its sensitivity is still uncertain due to its low incidence. On post natal assessment MRI is very important in planing surgical correction.

Conclusion: Congenital tibiofibular pseudoarthrosis is a very low frequency condition and uncertain prenatal diagnosis. Post natal radiological images and MRI are very important in diagnosis and treatment. Multidisciplinary team is required to achieve an integral rehabilitation