Tibial pseudoarthrosis is a fracture of the tibia (bone in the lower leg) that has not healed correctly. This incorrect healing of the bone is also called the „non-union” by the orthopedic doctors. In most cases, the condition is associated with neurofibromatosis, a genetic disorder characterized by tumors (neurofibromas) that grow in the nervous system and under the skin

Children with neurofibromatosis often have an inclination (bending) of the tibia that has a distinct orientation - an antero-lateral arch (towards the face) - that can lead to fracture and pseudoarthrosis.

Children may suffer from congenital pseudoarthrosis (present at birth) through which the bone can spontaneously fracture. But fortunately, congenital pseudoarthrosis is a very rare condition.

Symptoms of pseudoarthrosis are similar to those of osteoarthritis and include

➢ lack of mobility
➢ persistent pain
➢ joint clicks (cracments)
➢ in some cases, redness and even fever.

Children with anterolateral arch, without fracture, will wear orthotics throughout childhood. As the child grows, the risk of fracture tends to decrease.

When it’s associated with tibial dysplasia (abnormal development of the tibia), patients will be monitored throughout their lives.

It is recommended for children with fractures and pseudarthrosis.

The most common procedure involves the use of a bone graft and an intramedullary rod (placed inside the bone) to support healing.

In other cases, the patient may need to remove the abnormal portion of the bone and replace it with healthy, vascularized bone (with good blood flow) taken from the fibula (the second bone of the tibia. The sampling is done from the other leg of the patient

Both in the case of conservative treatment (without surgery) and after surgery, physical therapy has an essential red in correcting the curvature of the tibia (anterolateral arch).

Specific physical exercises, performed under the supervision of a physical therapist, aim at:

➢ Increasing joint mobility and flexibility
➢ Toning muscles
➢ Prevention of fractures.