Congenital Pseudoarthrosis of the Tibia Repaired with Massive Autograft and Tibia-Fibula Cross-Union

This case presents a skeletally mature patient with an ongoing pseudoarthrosis of the right tibia after several unsuccessful attempts at obtaining union during his childhood. He was treated with revision fixation and massive bone grafting of the right tibia and fibula to obtain not only tibia and fibula union but additionally a cross-union between the bones for enhanced and durable stability. The bone graft was supplemented with catabolic suppression using zoledronic acid and anabolic support using BMP-2.