# Reconstruction With the Contralateral Fibula for Isolated Congenital Pseudarthrosis of the Fibula

## TL;DR

A new surgical technique using the contralateral fibula successfully treats isolated congenital pseudarthrosis of the fibula in children.

## Contribution

A novel reconstruction technique using the contralateral fibula for treating isolated congenital pseudarthrosis of the fibula is introduced and successfully applied.

## Key findings

- All patients achieved bony union at the pseudarthrotic lesion of the affected fibula.
- No fractures or recurrence of pseudarthrosis occurred at the reconstructed donor sites.
- Patients showed mild ankle deformity but no functional impairment at skeletal maturity.

## Abstract

Congenital pseudarthrosis of the tibia (CPT) remains one of the most challenging conditions to manage in pediatric orthopedics. Fibular pseudarthrosis, often associated with CPT, is similarly resistant to treatment. In contrast, isolated congenital pseudarthrosis of the fibula (ICPF) is a rare condition for which no standardized treatment has been established. Here, we report four pediatric cases of ICPF treated with a novel reconstruction technique using the contralateral fibula. All patients achieved bony union at the pseudarthrotic lesion of the affected fibula. The donor sites of the contralateral fibula were reconstructed with β-tricalcium phosphate blocks. No fractures occurred at the reconstructed sites, and no recurrence of pseudarthrosis was observed. At final follow-up, which corresponded to skeletal maturity, all patients demonstrated mild ankle deformity on radiographs but no functional impairment.