A LONG-TERM STUDY OF THE DONOR-SITE ANKLE AFTER VASCULARIZED FIBULA GRAFTS IN CHILDREN

We reviewed the long-term course of the donor-site ankle after vascula rized fibula grafts in 13 children. The preventive and therapeutic eff ects of the tibio-fibular metaphyseal synostosis (T-F synostosis) agai nst valgus ankle deformity, which is one of the postoperative donor-si te problems, were evaluated based on three radiologic and clinical par ameters. Thirteen patients were divided into two groups: patients with or without simultaneous T-F synostosis when the fibula was taken, Thr ee patients underwent T-F synostosis secondarily after the development of the valgus deformity, Follow-up periods averaged 12.4 years, In th e patients with primary T-F synostosis, valgus deformity was only obse rved in one case. No functional disorder of the ankle joints was obser ved after T-F synostosis. In the patients without T-F synostosis, all the patients younger than 8 years old showed valgus deformity, in whic h the tilting angle averaged 6.3 degrees, In the three patients who un derwent T-F synostosis secondarily, the tilting angle normalized in ca ses in which the fixation was performed when the lateral wedging was i n a mild stage. There was a statistically significant difference in va lgus tilt angle between the two groups (with or without T-F synostosis ). (C) 1996 Wiley-Liss, Inc.