Open reduction intramedullary rod with synthetic bone graft for the treatment of radius ulna pseudoarthrosis with neurofibromatosis type 1: a case report

Background: Pseudoarthrosis is a false joint that occurs in cases of non-union and is commonly associated with neurofibromatosis. Treatment of refracture and non-union remains a challenge, and many methods have been attempted with varying results. Case Presentation: A 7-year-old, left-handed male sought consult at the Philippine Orthopedic Center (POC) last February 2016 with a complaint of left forearm deformity. This patient was diagnosed with neurofibromatosis type 1 with pseudoarthrosis of the radius and ulna. The pseudoarthrosis was treated with an application of an intramedullary rod and synthetic bone graft. Union and a full range of motion of the forearm were achieved at 1.5 years post-op. Conclusion: Pseudoarthrosis is a rare case of non-union that occurs spontaneously or after a minor trauma, most commonly associated with Neurofibromatosis Type 1. Since the condition is so rare, many methods have been attempted with varying results. Successful treatment of most atrophic non-union is achieved by optimizing the mechanical and biological environment of the pseudoarthrosis site.