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Asymmetrical Bilateral Tibial Dysplasia in a Pediatric Patient: A Rare and Complex Presentation

Original Article | Volume 12 | Issue 2 | May-August 2026 | Page: 36-39 | Tariq Altaf Mir, Haseeb Gani DOI- https://doi.org/10.13107/ijpo.2026.v12.i02.278 Open Access License: CC BY-NC 4.0 Copyright Statement: Copyright © 2026; The Author(s). Submitted: 03/02/2026; Reviewed: 01/03/2026; Accepted: 16/05/2026; Published: 10/08/2026 Authors: Tariq Altaf Mir [1], Haseeb Gani [1] [1] Department of Paediatric […]

Efficacy of Non-Vascularized Fibular Grafts in the Reconstruction of Large Long Bone Defects in the Pediatric Population

Original Article | Volume 12 | Issue 2 | May-August 2026 | Page: 19-25 | Rajashree Paidipati, Rudraprasad M S, Kiran Rajappa, Abhishek S Bhasme, Nandini Sanjay, Mohammed Yaqub DOI- https://doi.org/10.13107/ijpo.2026.v12.i02.274 Open Access License: CC BY-NC 4.0 Copyright Statement: Copyright © 2026; The Author(s). Submitted: 17/01/2026; Reviewed: 12/02/2026; Accepted: 09/05/2025; Published: 10/08/2026 Authors: Rajashree Paidipati […]

Asymmetrical Bilateral Tibial Dysplasia in a Pediatric Patient: A Rare and Complex Presentation

Efficacy of Non-Vascularized Fibular Grafts in the Reconstruction of Large Long Bone Defects in the Pediatric Population

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Asymmetrical Bilateral Tibial Dysplasia in a Pediatric Patient: A Rare and Complex Presentation

DOI- https://doi.org/10.13107/ijpo.2026.v12.i02.278

Open Access License: CC BY-NC 4.0

Submitted: 03/02/2026; Reviewed: 01/03/2026; Accepted: 16/05/2026; Published: 10/08/2026

Authors: Tariq Altaf Mir [1], Haseeb Gani [1]

[1] Department of Paediatric Orthopaedics Unit, Paras Health, Durganag, Dalgate, Srinagar, Jammu and Kashmir, India.

Address of Correspondence

Dr. Tariq Altaf Mir,
Department of Paediatric Orthopaedics Unit, Paras Health, Durganag, Dalgate, Srinagar, Jammu and Kashmir, India.
E-mail: mirtariqaltaf@gmail.com

Abstract

Bilateral tibial dysplasia is a very rare condition and has only been reported infrequently. We report a rare case of idiopathic bilateral tibial dysplasia in a 15-month-old child with asymmetric presentation. We managed the two sides differently and achieved a satisfactory union. Bilateral tibial dysplasia can be very challenging to manage, and the two sides may not behave similarly. Anterolateral bowing without fracture can have a better prognosis for union.
Keywords: Congenital pseudoarthrosis of the tibia, tibial dysplasia, congenital pseudoarthrosis of tibia.

References

1. Hefti F, Bollini G, Dungl P, Fixsen J, Grill F, Ippolito E, et al. Congenital pseudarthrosis of the tibia: History, etiology, classification, and epidemiologic data. J Pediatr Orthop B 2000;9:11-5.
2. Kesireddy N, Kheireldin RK, Lu A, Cooper J, Liu J, Ebraheim NA. Current treatment of congenital pseudarthrosis of the tibia: A systematic review and meta-analysis. J Pediatr Orthop B 2018;27:541-50.
3. Herring JA, editor. Disorders of the leg. In: Tachdjian’s Pediatric Orthopaedics. 5th ed. Amsterdam, The Netherlands: Elsevier; 2013. p. 713-58.
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5. Laine JC, Novotny SA, Weber EW, Georgiadis AG, Dahl MT. Distal tibial guided growth for anterolateral bowing of the tibia: Fracture may be prevented. J Bone J Surg Am 2020;102:2077-86.

How to Cite this Article: Mir TA, Gani H | Asymmetrical Bilateral Tibial Dysplasia in a Pediatric Patient: A Rare and Complex Presentation | International Journal of Paediatric Orthopaedics | May-August 2026; 12(2): 36-39.

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Efficacy of Non-Vascularized Fibular Grafts in the Reconstruction of Large Long Bone Defects in the Pediatric Population

DOI- https://doi.org/10.13107/ijpo.2026.v12.i02.274

Open Access License: CC BY-NC 4.0

Submitted: 17/01/2026; Reviewed: 12/02/2026; Accepted: 09/05/2025; Published: 10/08/2026

Authors: Rajashree Paidipati [1], Rudraprasad M S [1], Kiran Rajappa [1], Abhishek S Bhasme [1], Nandini Sanjay [1], Mohammed Yaqub [1]

[1] Department of Paediatric Orthopaedics, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India.

Address of Correspondence

Dr. Abhishek S. Bhasme
Department of Paediatric Orthopaedics, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India.
E-mail: dr.bhasme@gmail.com

Abstract

Background: Management of large long bone defects in the pediatric population remains a significant challenge in orthopedic surgery. These defects often arise secondary to chronic osteomyelitis, high-energy open fractures, or resection of benign and malignant bone tumors. Various reconstructive strategies have been employed, including cancellous bone grafting, free vascularized fibular grafting, and bone transport using external ring fixators. Although non-vascularized fibular grafts (NVFG) have demonstrated promising outcomes in adults, their utility in children is less clearly defined due to limited data on safety, efficacy, and long-term outcomes.
Objectives: This study aims to evaluate the clinical and radiological outcomes of non-vascularized autologous fibular grafts in the management of large long bone defects (>4 cm) in children, with specific focus on graft incorporation, time to union, preservation of the physis, and functional recovery.
Materials and Methods: An observational study was conducted on 20 children presenting with large long bone defects exceeding 4 cm. All patients underwent reconstruction using autologous non-vascularized fibular strut grafts. Grafts were fixed via internal fixation (plates or nails) or external fixation based on the bone affected, soft-tissue condition, and stability needs. Patients were followed for a minimum period of 6 months. Outcome measured included radiological union, graft resorption or remodeling, limb-length discrepancy, joint range of motion, and complications (graft fracture, non-union, and physeal injury).
Results: Of the twenty children, radiographic union was achieved in 18 by a mean of 9.4 ± 2.1 weeks (range: 7–13 weeks). Two cases demonstrated delayed union; one of which required an additional surgical procedure (revision grafting and fixation) to achieve union. At final follow-up, most patients regained full joint function; minor complications included one graft fracture, one physeal separation, and one implant failure. All patients were ambulatory and pain-free, with no recurrence of infection or graft failure.
Conclusion: NVFG, when employed in conjunction with rigorous infection control and suitable fixation, is a safe, effective, and technically feasible reconstructive option for large bone defects in children. There is relatively rapid incorporation of the graft with high union rates and low donor-site morbidity. Special caution is needed in larger defects and some cases may require revision.
Keywords: Non-vascularised fibular graft, pediatric gap non-union.

References

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3. Swamy MK, Rathi A, Gupta V. Results of non-vascularised fibular grafting in gap non-union of long bones in paediatric age group. J Clin Orthop Trauma 2013;4:180-4.
4. Loro A, Franceschi F, Fisha MM, Ewochu E, Mwanje G, Dal Lago A, et al. Autogenous bone graft in the management of post-osteomyelitis bone defects in children in a limited-resource setting – a retrospective cohort study with a minimum follow-up of 7 years. J Bone Jt Infect 2025;10:155-63.
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How to Cite this Article: Paidipati R, Rudraprasad M S, Rajappa K, Bhasme AS, Sanjay N, Yaqub M | Efficacy of Non- Vascularized Fibular Grafts in the Reconstruction of Large Long Bone Defects in the Paediatric Population | International Journal of Paediatric Orthopaedics | May-August 2026; 12(2): 19-25.

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