Table 6.
Patients with refractures after initial healing
| Patient number | Site of refracture | Diagnosis | Treatment of fracture | Time between index operation and refracture (years) | Classifications – Boyd [4], El-Rosasy-Paley et al. [14] | Age at refracture (years) | Fibular PA |
|---|---|---|---|---|---|---|---|
| 1 | Through different lesion | OFD | Frame without grafting | 3.7 | III, II | 10.4 | Yes |
| 2 | Original PA site | Idiopathic | Casting + zoledronic acid therapy + fibular transport and then regrafting + tibiofibular synostosis with two screws + BMP-2 and LCP; after two treatments of intravenously administered bisphosphonate, tibia healed but fibula not completely consolidated | 1.3 | V, I | 8 | Yes |
| 3 | Original PA site | NF | Casting tried for 3 months (no healing noticed); after zoledronic acid, healing achieved | 1.5 | II, I | 9.4 | No |
| 5 | Original PA site | NF | Regrafting + external fixation + proximal lengthening | 1.0 | II, I | 7 | Yes |
| 7 | Original PA site | NF | First fracture: FractureFrame + rod exchange without regrafting from titanium nail to FDNSecond fracture: Frame reapplication, regrafting, and rod exchange | First refracture, 1.1Second refracture, 6.4 | II, I | First refracture, 2.3Second refracture, 6.7 | Yes |
| 8 | Original PA site | NF | Frame reapplication without grafting and then Rush rod subtalar joint | 1.3 | II, I | 2.8 | Yes |
| 10 | Original PA site | OFD | Casting + zoledronic acid, healing achieved | 5.8 | III, I | 7.9 | No |
| 11 | Original PA site | NF | First fracture: Healed after 3 months of castingSecond fracture: Frame without grafting and rod insertion at time of frame removal | First refracture, 2.8Second refracture, 3.1 | II, I | First refracture, 5Second refracture, 5.3 | Yes |
BMP = bone morphogenetic protein; FDN = Fassier-Duval telescopic IM nail; LCP = locking compression plate; NF = neurofibromatosis; OFD = osteofibrous dysplasia; PA = pseudarthrosis.