الفهرس 
IntroductionOnly 14 pages are availabe for public view
Abstract
Congenital pseudoarthrosis of the tibia is an uncommon
disease defined as a disorder of the diaphysis with various
clinical presentations ranging from simple anterolateral tibial
angulation to complete non-union with extensive bone defects.
Congenital pseudoarthrosis of the tibia was first described by
Paget in 1891. There is True bone dysplasia with non union or
potential non union through a hamartomatous area in the tibia.
The defect in the bone is filled with mature, fibrous connective
tissue, and the exact pathogenesis still remains unclear. (1)
Treatment of Congenital pseudarthrosis of the tibia is
surgical, as natural progression of the disease is towards
worsening, deformity and shortening. The aim of surgical
treatment is to achieve bone union of the pseudoarthrosis while
restoring alignment in the leg to prevent the risk of recurrent
fracture and to preserve function and bone growth in the leg.(2,3)
Ilizarov was the first to use his fixation technique in
Congenital pseudarthrosis of the tibia, Small bone fragments
can be stabilized with this technique, a residual deformity can
gradually be restored, and length discrepancies in the affected
limb can be treated during the same surgical procedure.(4,5)
Intramedullary nailing associated with bone graft first
described in 1956 by charnley, the principle is based on
resection of areas of pseudarthosis associated with stable
Introduction
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intramedullary fixation and transfer of a large graft, the use of
nail or pins helps protect the reconstructed area during growth
and avoids having to change the internal fixation.(6,7)
The superiority of one treatment over another remains
difficult to determine. The many different clinical presentations
of Congenital pseudoarthrosis of the tibia, the effect of prior
treatment, the necessity of having a follow-up that is long
enough and until skeletal maturity, the age at surgery and the
few number of cases in each series make comparison of
treatments and evaluation of results difficult, there is no gold
standard surgical technique to successfully treat all types and
presentations of Congenital pseudoarthrosis of the tibia.(7)
Systematic reviews are types of literature reviews that
collect and analyze multiple research studies. Providing a
complete summary of current literature relevant to a research
question. Systematic reviews of randomized controlled trials
are key in the practice of evidence-based medicine, presented
as level I of evidence. (8)