Combined massive allograft and intramedullary vascularized fibula transfer: the Capanna technique for treatment of congenital pseudarthrosis of the tibia

Figures & data

Figure 1. A. Postoperative image after Capanna procedure for CPT. B. 8-plates on both distal tibias to correct for ankle valgus at the donor and receptor sites. C. Cross-union between the distal anastomosis of graft and tibia and the remnant distal fibula.

Table 2. Baseline characteristics

Procedure Patient		Age (years)	NF	Side	Paley classification	Previous procedures	Donor site
1	1	5.5	Yes	Right	4A	4	Contralateral
2	2	3.4	Yes	Left	1	0	Contralateral
3	3 ^a	12.7	Yes	Right	4A	1	Ipsilateral
4	3 ^a	16.5	Yes	Left	4B	0	Ipsilateral
5	4	3.0	Yes	Right	4A	0	Contralateral
6	5	5.1	Yes	Right	3	0	Ipsilateral
7	6	14.0	No	Right	4A	1	Ipsilateral

^aBilateral

Table 1. Results

Procedures	Patients	Primary proximal union	Refracture proximal	Primary distal union	Refracture distal
7	6	7	0	3	4

Table 3. Postoperative outcomes

Procedure Patient		Follow-up (years)	LOS ^a (days)	Consolidation proximal part tibia	Months to consolidation proximal	Months to consolidation distal	Compli- cation < 30 days	Complication 1 > 30 days	Complication 2 > 30 days
1	1	9.6	5	Yes	8	13	–	Bilateral valgus deformity ankle	Leg length discrepancy
2	2	9.4	6	Yes	5	13	–	Bilateral valgus deformity ankle	Leg length discrepancy
3	3	7	6	Yes	5	4 ^b	–	Fracture distal tibia
4	3	3	3	Yes	10	– ^c	–	Fracture distal tibia and fracture plate	Pseudarthrosis requiring amputation
5	4	4.1	6	Yes	2	2 ^b	–	Persisting distal Pseudarthrosis	Valgus deformity proximal tibia
6	5	3.7	5	Yes	7	2 ^b	–	Fracture distal tibia
7	6	0.9	4	Yes	5	3 ^b	–	Fracture distal tibia

^a Length of stay in hospital. ^b Consolidation after additional procedure. ^c Below-knee amputation after refracture.