Fibula regeneration following non-vascularized graft harvest in children.
A peculiarity of non-vascularized fibular harvest is that the donor site regenerates new bone provided periosteum is preserved. We prospectively investigated the regenerated fibula quantitatively and studied clinical implications of non-regeneration.



The fibula was harvested using a periosteum preserving technique. Only fibulae from healthy legs were harvested. X-rays were done pre- and post-operatively at three and six months. Clinical assessment of donor limb included pain, gait, motor and sensory examination. Fibular regeneration was quantified using defined length and width criteria.



There were 16 children with 21 harvested fibula. About 65 % of total fibular length was available for use as graft. There was regeneration of fibula similar to the pre-operative dimensions as early as six months in 71 % of cases. There were no clinical morbid findings as assessed at six months follow up despite non-continuity being observed in 29 % of cases. The predominant site for non-continuity was middle third-distal third junction.



Periosteal preserving non-vascularized fibula grafting was a low morbidity procedure. In two-third of the cases, there was regeneration of fibula comparable to pre-operative dimensions as early as six months. The non-continuous regeneration had no clinical implications.
Department of Pediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, 110031, India. rachna_anila@yahoo.co.in.|, 4/103, East End Apartments, Mayur Vihar Ph-1 Ext., Delhi, 110096, India. rachna_anila@yahoo.co.in.
Anil
A
Agarwal
Department of Pediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, 110031, India.
Anubrat
A
Kumar
D001861:Bone Regeneration / Q000502:physiology*; D016025:Bone Transplantation / Q000379:methods*; D002648:Child; D005360:Fibula / Q000503:physiopathology* / Q000637:transplantation*; D006801:Humans; D010521:Periosteum / Q000503:physiopathology; D011446:Prospective Studies; D020858:Tissue and Organ Harvesting; D060053:Transplant Donor Site
Children; Fibula; Graft; Non-vascularized; Regeneration