A radiographic scoring system to assess healing in congenital pseudarthrosis of the tibia.

The aim of this study was to determine whether an established radiographic union scoring system for tibial fracture healing (RUST) is reliable when used in neurofibromatosis (NF1) patients with congenital pseudarthrosis of the tibia (CPT) treated by intramedullary fixation. Four individuals reviewed 36 sets of radiographs from 12 NF1 patients with CPT (preoperative, and 6 months and 1 year postoperative). Intraobserver reliability (κ-value 0.89) and interobserver reliability (κ-value 0.76) were high. The modified RUST scoring system is a useful tool when faced with the challenge of postoperative radiographic evaluation of the tibia in NF1 patients with CPT.