On 24/11, Doctor Hoang Hai Duc, Head of the Pediatric Orthopedics Department at National Children's Hospital, announced that nine weeks after surgery using a new method, the patient had her cast removed and began physical therapy. Soon, she will be able to go to school independently, manage daily activities, and play with friends—something she could not do for the past six years.

"Seeing my child walk on her own, I still feel like I am dreaming. Before, wherever we went, her parents had to carry her. We took her to school four times a day, and all her personal activities were very difficult," the patient's mother shared.

Doctors examine the patient's leg. *Photo: Hospital provided*

The girl suffered from a rare condition known as congenital pseudarthrosis of the tibia from when she first started to walk. This disease causes the tibia to develop abnormally, making it prone to fractures, difficult to heal, and progressively bowing, leading to limb shortening, deformity, and reduced mobility. Without effective treatment, children face the risk of permanent disability.

Previously, the family had brought the girl to National Children's Hospital for conservative treatment with orthopedic braces to limit deformity. Doctors performed three surgeries, but the fractured bone still did not heal.

Faced with this challenging case, Doctor Duc and his team re-evaluated the entire process and decided to apply the advanced technique of vascularized periosteal flap grafting. The surgeons harvested a tibial periosteal flap from the healthy leg, along with its nourishing blood vessels, and transferred it to the injured leg.

The surgery lasted 4,5 hours and required high precision. The surgical team removed the pseudarthrosis site and all pathological periosteum, stabilizing it with plates and screws. Afterwards, doctors used microsurgical techniques to connect blood vessels, ensuring the new periosteal flap was viable and integrated into the graft site.

According to Doctor Duc, this is one of the most challenging conditions to treat in pediatric orthopedic trauma. The application of microsurgical periosteal flap grafting offers superior bone healing speed and quality compared to older methods. "The success of the surgery also stems from the Orthopedics Department's extensive experience in complex microsurgical techniques, such as nerve grafting or lymphedema treatment performed previously," Doctor Duc said.

Le Nga