{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T15:02:42Z","timestamp":1775142162603,"version":"3.50.1"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>McCune-Albright syndrome (MAS) is a rare disease. MAS manifests in the skeletal system as Fibrous dysplasia (FD). In MAS patients, bone lesions often result in fractures under weight-bearing forces during childhood, and pseudarthrosis formation is highly likely after fractures. There is currently no ideal treatment for fractures in children with MAS. This case study presents the innovative application of the cross-union technique in treating a 14-year-old female MAS patient with a distal tibial and fibular fracture nonunion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The patient had a history of conservative treatment with persistent symptoms, including an inability to bear weight and walk independently. A \u201ccross-union\u201d procedure was performed using a Fassier-Duval rod, locking plate, and K-wire fixation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At the final follow-up 12 months postoperatively, x-rays revealed a stable \u201ccross-union\u201d bone connection at the distal ends of the tibia and fibula, with no occurrence of refracture or other complications. The Radiographic Union Score for Tibial Fractures (RUST) was 12, and the Olerud Molander Ankle Score was 60.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We successfully applied the \u201ccross-union\u201d technique to a MAS child with nonunion after a distal tibiofibular fracture. We look forward to further improvement and promotion of the \u201ccross-union\u201d technology in the future, bringing new hope for treating fractures in MAS\/FD children.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2025.1663626","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T04:14:59Z","timestamp":1760415299000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Cross-union surgery for tibiofibular fractures in McCune-Albright syndrome: a case report and literature review"],"prefix":"10.3389","volume":"13","author":[{"given":"Hui","family":"Zhu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiwei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanjie","family":"Zhuang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pengfei","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuping","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,14]]},"reference":[{"key":"B1","first-page":"1","article-title":"McCune-Albright syndrome","volume-title":"StatPearls","author":"Holbrook","year":"2024"},{"key":"B2","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1007\/s00223-019-00550-z","article-title":"Fibrous dysplasia of bone and McCune-Albright syndrome: a bench to bedside review","volume":"104","author":"Hartley","year":"2019","journal-title":"Calcif Tissue Int"},{"key":"B3","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1210\/endrev\/bnz011","article-title":"Fibrous dysplasia\/McCune-Albright syndrome: a rare, mosaic disease of Galpha s activation","volume":"41","author":"Boyce","year":"2020","journal-title":"Endocr Rev"},{"key":"B4","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1186\/s13023-019-1102-9","article-title":"Best practice management guidelines for fibrous dysplasia\/McCune-Albright syndrome: a consensus statement from the FD\/MAS international consortium","volume":"14","author":"Javaid","year":"2019","journal-title":"Orphanet J Rare Dis"},{"key":"B5","doi-asserted-by":"publisher","first-page":"20101","DOI":"10.1073\/pnas.1114656108","article-title":"Wnt\/beta-catenin signaling is differentially regulated by Galpha proteins and contributes to fibrous dysplasia","volume":"108","author":"Regard","year":"2011","journal-title":"Proc Natl Acad Sci U S A"},{"key":"B6","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1002\/jbmr.4463","article-title":"Long bone fractures in fibrous dysplasia\/McCune-Albright syndrome: prevalence, natural history, and risk factors","volume":"37","author":"Geels","year":"2022","journal-title":"J Bone Miner Res"},{"key":"B7","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1097\/BPO.0b013e318221ebce","article-title":"\u201c4-in-1 osteosynthesis\u201d for atrophic-type congenital pseudarthrosis of the tibia","volume":"31","author":"Choi","year":"2011","journal-title":"J Pediatr Orthop"},{"key":"B8","doi-asserted-by":"publisher","first-page":"547","DOI":"10.3390\/children8070547","article-title":"Cross-Union surgery for congenital pseudarthrosis of the tibia","volume":"8","author":"Shannon","year":"2021","journal-title":"Children (Basel)"},{"key":"B9","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1302\/1863-2548.13.180147","article-title":"Congenital pseudarthrosis of the tibia: biological and biomechanical considerations to achieve union and prevent refracture","volume":"13","author":"Paley","year":"2019","journal-title":"J Child Orthop"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1688","DOI":"10.1056\/NEJM199112123252403","article-title":"Activating mutations of the stimulatory G protein in the McCune-Albright syndrome","volume":"325","author":"Weinstein","year":"1991","journal-title":"N Engl J Med"},{"key":"B11","doi-asserted-by":"publisher","first-page":"98","DOI":"10.3892\/mco.2018.1636","article-title":"Fibrous dysplasia of bone: surgical management options and outcomes of 22 cases","volume":"9","author":"Fang","year":"2018","journal-title":"Mol Clin Oncol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1186\/1750-1172-7-S1-S1","article-title":"The surgical management of fibrous dysplasia of bone","author":"Stanton","year":"2012","journal-title":"Orphanet J Rare Dis"},{"key":"B13","doi-asserted-by":"publisher","first-page":"e492","DOI":"10.1097\/BPO.0000000000002097","article-title":"Intramedullary nailing for lower limb polyostotic fibrous dysplasia in children: a long-term follow-up study","volume":"42","author":"Ippolito","year":"2022","journal-title":"J Pediatr Orthop"},{"key":"B14","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/s10195-023-00705-7","article-title":"Lower-limb intramedullary nailing in patients with polyostotic fibrous dysplasia who had a previous unsuccessful treatment. A report of 48 cases","volume":"24","author":"Ippolito","year":"2023","journal-title":"J Orthop Traumatol"},{"key":"B15","first-page":"455","article-title":"Studies of longitudinal bone growth resulting in an extensible nail","volume":"14","author":"Bailey","year":"1963","journal-title":"Surg Forum"},{"key":"B16","doi-asserted-by":"publisher","first-page":"e392","DOI":"10.1097\/BPO.0000000000001324","article-title":"Fassier-Duval rods are associated with superior probability of survival compared with static implants in a cohort of children with osteogenesis Imperfecta deformities","volume":"39","author":"Spahn","year":"2019","journal-title":"J Pediatr Orthop"},{"key":"B17","doi-asserted-by":"publisher","first-page":"2238","DOI":"10.1097\/CORR.0000000000000429","article-title":"Dual interlocking telescopic rod provides effective tibial stabilization in children with osteogenesis imperfecta","volume":"476","author":"Shin","year":"2018","journal-title":"Clin Orthop Relat Res"},{"key":"B18","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1007\/s12178-022-09779-y","article-title":"Anterolateral tibial bowing and congenital pseudoarthrosis of the tibia: current concept review and future directions","volume":"15","author":"Siebert","year":"2022","journal-title":"Curr Rev Musculoskelet Med"},{"key":"B19","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1097\/BPB.0000000000001040","article-title":"Clinical study of a new type of telescopic rod for the treatment of congenital pseudarthrosis of the tibia in children","volume":"32","author":"Liu","year":"2023","journal-title":"J Pediatr Orthop B"},{"key":"B20","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1186\/s13018-021-02649-2","article-title":"Application of the \u201ctelescopic rod\u201d in a combined surgical technique for the treatment of congenital pseudarthrosis of the tibia in children","volume":"16","author":"Liu","year":"2021","journal-title":"J Orthop Surg Res"},{"key":"B21","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1097\/TA.0b013e3181a7c16d","article-title":"Development of the radiographic union score for tibial fractures for the assessment of tibial fracture healing after intramedullary fixation","volume":"68","author":"Whelan","year":"2010","journal-title":"J Trauma"},{"key":"B22","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1007\/BF00435553","article-title":"A scoring scale for symptom evaluation after ankle fracture","volume":"103","author":"Olerud","year":"1984","journal-title":"Arch Orthop Trauma Surg (1978)"},{"key":"B23","doi-asserted-by":"publisher","first-page":"e623","DOI":"10.1097\/BPO.0000000000002138","article-title":"Combination treatment by cross-union of the tibia and fibula, autogenic iliac bone grafting, reliable fixation and bone morphogenetic proteins for the treatment of refractory congenital pseudarthrosis of the tibia","volume":"42","author":"Wu","year":"2022","journal-title":"J Pediatr Orthop"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1663626\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T04:15:00Z","timestamp":1760415300000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1663626\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,14]]},"references-count":23,"alternative-id":["10.3389\/fped.2025.1663626"],"URL":"https:\/\/doi.org\/10.3389\/fped.2025.1663626","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,14]]},"article-number":"1663626"}}