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

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.