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Anterolateral Tibial Bowing



- Discussion:
    - condition is a part of the spectrum of the bowing-pseudarthrosis disorder seen in neurofibromatosis;
           - tibial pseudarthrosis may be present at birth, or it may present later on following a frx from an anterolaterally bowed tibia;
    - this disorder should not be confused w/ posteromedial tibial bowing:

- Radiographs:  



- Treatment:
    - early application of a total contact orthosis (patellar bearing);
           - in infant & younger child, orthosis should include knee & ankle;
           - in older child, a high ankle-foot orthosis is sufficient;
    - prophylactic grafting in absence of fracture is controversial;
    - corrective osteotomy is contraindicated since it can lead to pseudarthrosis



Prophylactic bypass grafting and long-term bracing in the management of anterolateral bowing of the tibia and neurofibromatosis-1.