Rationale: given the recalcitrant behaviour of pseudarthrosis in osteogenesis imperfecta (OI) and congenital pseudarthrosis of the tibia (CPT), there is no ideal solution to treat such challenging deformities. The reconsideration of the already known principles, by using the modern technology, may generate new treatment methods.

Aim: the present paper presents the preliminary results of an original reconstruction procedure used to treat large bone defects in paediatric orthopaedics. A case series study, the surgical technique, complications and illustrative cases are presented.

Methods and results: 3 cases of pseudarthrosis in OI and 2 cases of CPT were operated by using this technique. The principles of the method are to create an optimal osteoconductive and osteoinductive environment by using a bone autograft, bone allograft and bone graft substitutes and to provide a good stabilisation of the bones. We operated 3 patients with OI and 2 patients with CPT. Four patients had multiple previous surgeries. The follow-up period ranged from 3 to 28 months. Four of the five patients are able to ambulate independently at the moment this paper was written.

Discussion: we believe that the present technique could be a reliable alternative to other procedures, especially in cases of repeated failures.