Disease Progression Without Fracture in Anterolateral Tibial Curvature

Case: A 15-year-old girl presented with isolated anterolateral tibial bowing without fracture, an unusual manifestation. The deformity was initially corrected with a double-level osteotomy sparing the apex and intramedullary nail fixation. A second corrective procedure was performed for residual deformity, resulting in satisfactory alignment and union. Conclusion: Congenital tibial pseudarthrosis most often progresses to fracture in early childhood, but this rare presentation without fracture highlights the variability of the condition. Successful correction was achieved through staged, apex-preserving, double-level osteotomies and intramedullary fixation, providing a potential strategy for atypical cases.