Fig. 4.

This neonate with NF1 was born with a tibial pseudarthrosis that required several surgical attempts at achieving union. By age 5 years, he presented with a united tibia, but progressive genu valgum, requiring hinged KAFO protection, and a 3 cm limb length discrepancy. Seven months following pan genu guided growth, the mechanical axis has been restored and bracing facilitated. The metaphyseal screws were removed and will likely be reinserted in the future. Per parental discretion, tethering of his left tibia is an option, in addition to the planned, eventual lengthening of his right tibia/fibula