Three children with tibial pseudarthrosis were treated with cutaneous-bone pedicle grafts in order to determine whether such a method would constitute a successful form of therapy for this condition at this age level.
Although the principle involved appeared sound, the operation as described is not recommended. Union between the graft and the upper tibial fragment occurred rapidly. Technical difficulties may have been the cause of the delay in fusion at the lower end. It may be possible to overcome these difficulties by the use of a bone pedicle graft from another area, such as the ulna. Accurate approximation of the graft to the tibial fragments at the time of the initial transfer might then be possible. This would appear advantageous.
These results have been placed on record, so that the obvious errors may be avoided by others who may carry forward the technique. It was first used without previous knowledge that a procedure based on the same principle had been employed by European orthopaedic surgeons at the turn of the century.