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. 2022 Jun 23;17(1):245.
doi: 10.1186/s13023-022-02375-w.

Analysis of risk factors affecting union and refracture after combined surgery for congenital pseudarthrosis of the tibia: a retrospective study of 255 cases

Zhuoyang Li #  1 , Hui Yu #  2 , Yiyong Huang  3 , Yaoxi Liu  3 , Guanghui Zhu  3 , Qian Tan  3 , Haibo Mei  4 , Ge Yang  5
Affiliations

Analysis of risk factors affecting union and refracture after combined surgery for congenital pseudarthrosis of the tibia: a retrospective study of 255 cases

Zhuoyang Li et al. Orphanet J Rare Dis. .

Abstract

Background: Congenital pseudarthrosis of the tibia (CPT) is a rare disease occurring in children. The aim of this study is to identify the factors affecting bone union and re-fracture after surgery for CPT and to provide reliable evidence for clinics.

Methods: We collected the detailed information of 255 cases with Crawford IV CPT treated by combined surgery in our hospital from 2013 to 2020. Basic characteristics were recorded. Univariate variance and logistic regression analysis were used to compare the correlations between factors and outcomes.

Results: 92.5% of patients achieved primary union, 7.5% of patients had non-union and 13.3% of patients had re-fracture. Logistic regression analysis showed that age at index surgery (Coef. = 0.171, 95%CI 0.015-0.327, P = 0.032), and CPT location (Coef. = - 1.337, 95%CI - 2.218-0.456, P = 0.003) had statistical differences, while no factors had significant correlation with re-fracture. Furthermore, ROC curve showed that the optimal age threshold for first surgery was 2.37 years old.

Conclusions: For patients with Crawford IV CPT treated by combined surgery, the younger the age at index surgery and the closer the CPT location to the distal end, the easier to achieve bone union.

Keywords: Combined surgery; Congenital pseudarthrosis of the tibia; Refracture; Union.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The inclusion strategy
Fig. 2
Fig. 2
Preoperative and postoperative X-rays of combined surgery with cross-union. A preoperative X-ray; B postoperative X-ray within 7 days; C postoperative X-ray after primary union
Fig. 3
Fig. 3
Preoperative and postoperative X-rays of combined surgery without cross-union. A preoperative X-ray; B postoperative X-ray within 7 days; C postoperative X-ray after primary union
Fig. 4
Fig. 4
This figure shows the ROC Curve. The abscissa is 1-specificity, the ordinate is sensitivity. According to the curve, cut-off value is 2.37 years old
See this image and copyright information in PMC

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