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Case Reports
. 2022 Aug;12(8):80-84.
doi: 10.13107/jocr.2022.v12.i08.2974.

Transient Hypertension in a case of Congenital Pseudarthrosis of Tibia treated with Ring Fixator: A Case Report

Parth Shah  1 , Nareshkumar Satyanarayan Dhaniwala  1 , Vivek Jadawala  1 , Ankur Salwan  1 , Mukund Naresh Dhaniwala  1 , Rahul Agola  1
Affiliations
Case Reports

Transient Hypertension in a case of Congenital Pseudarthrosis of Tibia treated with Ring Fixator: A Case Report

Parth Shah et al. J Orthop Case Rep. 2022 Aug.

Abstract

Introduction: Congenital pseudarthrosis of tibia is an uncommon condition leading to gradually progressive deformity, shortening of the limb and disability. The condition is notorious for failure of treatment and need of multiple operations. A combination of open reduction, thorough excision of abnormal tissue at the pseudarthrosis site, intramedullary nailing, ring fixator application, and distraction to achieve bone equalization has proved successful.

Case report: A case of congenital pseudarthrosis of the left tibia and fibula associated with neurofibromatosis treated by open reduction, intramedullary nailing, ring fixator application, and distraction at corticotomy to cause compression at the pseudarthrosis site and limb length equalization is being reported due to uncommon occurrence of transient hypertension in the child as a complication of ring fixator.

Conclusion: Transient hypertension is a rare complication seen in children after application of ring fixator. Its diagnosis and control require proper perioperative assessment of child regarding blood pressure (BP), monitoring of BP during distraction period and period of application of ring fixator, and its treatment under care of pediatrician.

Keywords: Congenital; corticotomy; distraction; pseudarthrosis; ring fixator; tibia; transient hypertension.

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Conflict of interest statement

Conflict of Interest: Nil

Figures

Figure 1
Figure 1
Multiple café au lait spots on back of the trunk.
Figure 2
Figure 2
X-ray of left leg Ap and lateral views showing bony discontinuity in both the tibia and fibula at the lower thirds shaft with narrowing and sclerosis of bone ends at the pseudarthrosis site.
Figure 3
Figure 3
Immediate post-operative X-rays showing corticotomy site with a gap, between the first and second ring and good contact of the freshened bone ends at the pseudarthrosis site in tibia.
Figure 4
Figure 4
X-ray lateral view of leg 3 months after surgery with fixator and intramedullary nail in place, showing distraction and new bone formation at the corticotomy site and good contact at pseudarthrosis of tibia.
See this image and copyright information in PMC

References

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