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 vascularized fibula grafts in 13 children. The preventive and therapeutic effects of the tibio-fibular metaphyseal synostosis (T-F synostosis) against valgus ankle deformity, which is one of the postoperative donor-site problems, were evaluated based on three radiologic and clinical parameters. Thirteen patients were divided into two groups: patients with or without simultaneous T-F synostosis when the fibula was taken. Three patients underwent T-F synostosis secondarily after the development of the valgus deformity. Follow-up periods averaged 12.4 years. In the patients with primary T-F synostosis, valgus deformity was only observed in one case. No functional disorder of the ankle joints was observed after T-F synostosis. In the patients without T-F synostosis, all the patients younger than 8 years old showed valgus deformity, in which the tilting angle averaged 6.3 degrees. In the three patients who underwent T-F synostosis secondarily, the tilting angle normalized in cases in which the fixation was performed when the lateral wedging was in a mild stage. There was a statistically significant difference in valgus tilt angle between the two groups (with or without T-F synostosis).
Omokawa
S
S
Department of Orthopedic Surgery, Nara Medical University, Japan.
Tamai
S
S
Takakura
Y
Y
Yajima
H
H
Kawanishi
K
K
D000293:Adolescent; D000843:Ankle Joint; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005360:Fibula / Q000098:blood supply / Q000473:pathology / Q000637:transplantation*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007592:Joint Diseases / Q000209:etiology; D007593:Joint Instability / Q000209:etiology; D008137:Longitudinal Studies; D008297:Male; D010146:Pain / Q000209:etiology; D011183:Postoperative Complications; D011542:Pseudarthrosis / Q000151:congenital / Q000601:surgery; D016059:Range of Motion, Articular; D013977:Tibia / Q000601:surgery