Congenital tibial pseudarthrosis is a specific type of bone disjoint disease of unknown etiology that can occur at birth or after birth. Congenital tibial pseudarthrosis is most often seen in the lower middle third of the tibia, sometimes in the ipsilateral fibula, and occasionally in other areas, such as the first rib, clavicle, humerus, radius, ulna and femur, of which tibial pseudarthrosis is one of the most difficult to treat. A. Etiology: The true cause of the disease is still unknown. Many scholars have proposed that the disease is closely related to neurofibroma, but coffee spots and neurofibroma nodules are rarely found at birth. The disease is rarely found in the first 6 months of life and is gradually detected with age. Pathology and typing: The classification of congenital tibial pseudarthrosis is mainly based on pathological changes and is generally divided into three types. Clinical manifestations: The tibial pseudarthrosis is rarely found after birth, and most of them appear 1-2 years after birth with tibial curvature, usually determined by painful visits due to fracture. Sometimes there are coffee spots around the child’s body, shortened limbs on the affected side, smaller limbs and smaller feet, or inversion of the foot and bending of the tibia. When the pseudarthrosis is formed, there may be abnormal activity, no obvious local pressure pain, shortening of the affected limb and walking with limp. The pseudarthrosis exists at the junction of the middle and lower 1/3 of the tibia, the ends of the pseudarthrosis are tapered, the middle bone is resorbed and disappeared, the bone cortex is thinned, and the fibula sometimes shows the same performance; 2, the tibia has an anterior tibial arch at the junction of the middle and lower 1/3 of the tibia, the bone cortex is thickened, the bone marrow cavity is fibrotic, the tibia is shorter, and there are cystic changes in the marrow cavity; 3, the tibia is angled backward and outward, it is shorter, the bone is thickened, and the marrow cavity may not changes. V. Treatment: Congenital tibial pseudarthrosis is an extremely difficult disease to treat, and many scholars have proposed many surgical methods, but they have not achieved the desired effect. During the treatment process, the lower limb is often shortened, and even causes disability with the possibility of amputation. For those who have not formed a pseudarthrosis but only have a bent tibia, surgery to correct the deformity is contraindicated, and once surgery is performed, a pseudarthrosis will be formed, resulting in unimaginable consequences. For those who have not formed a pseudarthrosis, cystic changes have been formed in the tibia, so cystectomy and bone grafting should be carried out carefully, and before the bone tissue is completely repaired, the lower limb must be protected with a brace, which may prevent the occurrence of pseudarthrosis. If the tibia bends forward and outward and the sclerosis is serious, the diseased periosteum should be fully excised and autologous bone grafting should be performed, and at the same time, there should be a strong external fixation to receive satisfactory results. For those who have formed a pseudarthrosis, it is more appropriate to operate after the age of 6-7 years, because the bones of older children are thicker and harder than those of young children, and sufficient amount of cancellous bone and sufficient length of bone plate can be taken during the operation to ensure the fracture healing. The following methods are generally available: 1.Boyd surgery 2.Sofield method 3.Free fibula grafting 4.Ilizarov compression lengthening