Surgical Correction of Congenital Pseudoarthrosis of the Tibia: Use of the Williams Intramedullary Rod and Recombinant Human Bone Morphogenetic Protein-2

Congenital pseudoarthrosis of the tibia is a rare condition that is difficult to treat successfully. A variety of surgical techniques have been described to treat this condition, all with inconsistent results. We describe our surgical technique for this condition, consisting of complete pseudoarthrosis resection, intramedullary fixation using a Williams rod, iliac crest bone grafting, and addition of bone morphogenetic protein. This technique improves the mechanical alignment of the tibia, provides prolonged intramedullary protection of the bone, and delivers a biological stimulus for healing in this pathologic condition. We have had excellent success using this technique.