Congenital Tibial Pseudarthrosis Managed with Ipsilateral Vascularized Fibula Transfer

Congenital pseudarthrosis is a difcificult clinical challenge with upwards of 40–50 % amputation rate. Multiple procedures are available to the clinician for management. The area of nonunion is thought to be “avascular” and contributes to the failure of traditional bone grafting techniques. Many reports describe the use of a contralateral vascularized fibula transfer to achieve union. This requires operative intervention on the normal limb with its inherent potential complications. This case describes the use of an ipsilateral vascularized fibula, avoiding the potential morbidity on the contralateral limb as the source of the graft and the greater technical difficulty with a free transfer. The requirement of a “good” ipsilateral fibula limits patient eligibility.