Congenital Pseudarthrosis of the Fibula: Direct Surgical Repair

Isolated congenital pseudarthrosis of the fibula (not associated with congenital dysplasia of the tibia or systemic disorders such as neurofibromatosis type I or fibrous dysplasia) is an uncommon entity. It can lead to local symptoms, progressive valgus deformity of the ankle and fibular hypoplasia, and mild leg length inequality. We describe here a case of direct surgical repair of an isolated congenital pseudarthrosis of the fibula by a combination of pseudarthrosis excision, intercalary iliac crest bone grafting, and internal fixation with a standard dynamic compression plate (DCP)Dynamic compression plate (DCP). The graft incorporated uneventfully, and the implant was subsequently removed electively. At 3-year follow-up, the ankle was clinically normal, valgus deformity of the distal tibial epiphysis had normalized, and the patient was without complaint.