This 2019 expert opinion by Paley synthesizes the pathobiology, pathomechanics, and outcomes of congenital pseudarthrosis of the tibia. It introduces the Paley Classification and provides the biomechanical rationale for intentional tibio-fibular cross-union combined with zoledronic acid and BMP-2. The central question: why does every established technique fail half the time, and what anatomic and biological strategy can break that ceiling?
This 2019 expert opinion by Paley synthesizes the pathobiology, pathomechanics, and outcomes of congenital pseudarthrosis of the tibia. It introduces the Paley Classification and provides the biomechanical rationale for intentional tibio-fibular cross-union combined with zoledronic acid and BMP-2. The central question: why does every established technique fail half the time, and what anatomic and biological strategy can break that ceiling?