[Diagnostic and therapeutic problems of congenital pseudarthrosis of the lower leg in children].

So-called pseudarthrosis of the lower leg is a rare condition whose treatment entails major therapeutic problems. The first symptoms of this disease are structural changes thinning, and sclerosis of the tibia and fibula, as well as varus and antecurvation malposition? of the axis. In all of the authors' patients the pseudarthrosis occurred as a secondary phenomenon, three times in attempts to correct the lower leg axis surgically; in two children spontaneous fractures occurred due to fatigue and in two others after stumbling. In all seven of the surgically treated children and in three of the six in the outpatient group café-au-lait spots were seen. The neurofibromatosis was also confirmed by histological examinations in all of the surgically treated children. Not only the views concerning etiology, but also therapy have changed. Our present treatment method is undoubtedly a success as compared to that used on our first patients. On the basis of our surgical experience so far we can recommend the following method: resection of the pseudarthrosis with removal of all pathologically changed tissue (also by fraising), insertion of Küntscher nails from the heel to the tibia, adequate covering of the pseudarthrosis location with spongiosa grafts from the pelvic ridge. If necessary, the intervention should be repeated.