title: Relationship between postoperative complications and fibular integrity in congenital pseudarthrosis of the tibia in children.
abstract: BACKGROUND
  This study aimed to investigate the relationship between postoperative complications and fibular integrity in congenital pseudarthrosis of the tibia (CPT) in children.
  
  
  METHODS
  A retrospective study was performed in 59 patients with Crawford type IV CPT who were treated with combined surgical technique from 2007 to 2011. The patients were divided into two groups, the CPT with fibular pseudarthrosis (group A) and CPT with intact fibula groups (group B), on the basis of fibula status after the union of CPT. The incidence rates of refracture, ankle valgus, tibial valgus, and limb length discrepancy in the two groups were investigated.
  
  
  RESULTS
  In group A, 14 (36.8%) cases had refracture, 30 (78.9%) had ankle valgus; 27 (71%) exhibited tibial valgus with an average tibial valgus of 7° (6°-20°), and 24 (63.2%) had limb length discrepancy with an average limb length of 1.26 cm (0.6-4.4 cm). In group B, 2 (9.5%) cases had refracture, 11 (52.4%) had ankle valgus, 8 (42.9%) had tibial valgus with an average tibial valgus deformity of 2.9° (6°-13°), and 13 (61.9%) had limb length discrepancy with an average limb length of 1.48 cm (0.5-5 cm). Significant difference in refracture and ankle valgus was found between groups A and B (P<0.05).
  
  
  CONCLUSIONS
  After the union of CPT, patients with fibular pseudarthrosis showed higher incidence of refracture and ankle valgus than those with intact fibula. Attention should be paid to the presence of fibular pseudarthrosis when managing CPT.
authors.affiliation: Department of Pediatric Orthopedics, Hunan Children's Hospital, Pediatric Academy of University of South China, Changsha City, Changsha, China.
authors.forename: Yao-Xi
authors.initials: YX
authors.lastname: Liu
authors.affiliation: Department of Pediatric Orthopedics, Hunan Children's Hospital, Pediatric Academy of University of South China, Changsha City, Changsha, China. meihaiboprof@outlook.com.
authors.forename: Hai-Bo
authors.initials: HB
authors.lastname: Mei
authors.affiliation: Department of Pediatric Orthopedics, Hunan Children's Hospital, Pediatric Academy of University of South China, Changsha City, Changsha, China.
authors.forename: Guang-Hui
authors.initials: GH
authors.lastname: Zhu
authors.affiliation: Department of Pediatric Orthopedics, Hunan Children's Hospital, Pediatric Academy of University of South China, Changsha City, Changsha, China.
authors.forename: Rong-Guo
authors.initials: RG
authors.lastname: He
authors.affiliation: Department of Pediatric Orthopedics, Hunan Children's Hospital, Pediatric Academy of University of South China, Changsha City, Changsha, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Liu
authors.affiliation: Department of Pediatric Orthopedics, Hunan Children's Hospital, Pediatric Academy of University of South China, Changsha City, Changsha, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Tang
authors.affiliation: Department of Pediatric Orthopedics, Hunan Children's Hospital, Pediatric Academy of University of South China, Changsha City, Changsha, China.
authors.forename: Jiang-Yan
authors.initials: JY
authors.lastname: Wu
authors.affiliation: Department of Pediatric Orthopedics, Hunan Children's Hospital, Pediatric Academy of University of South China, Changsha City, Changsha, China.
authors.forename: Wei-Hua
authors.initials: WH
authors.lastname: Ye
authors.affiliation: Department of Pediatric Orthopedics, Hunan Children's Hospital, Pediatric Academy of University of South China, Changsha City, Changsha, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Hu
authors.affiliation: Department of Pediatric Orthopedics, Hunan Children's Hospital, Pediatric Academy of University of South China, Changsha City, Changsha, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Tan
authors.affiliation: Department of Pediatric Orthopedics, Hunan Children's Hospital, Pediatric Academy of University of South China, Changsha City, Changsha, China.
authors.forename: An
authors.initials: A
authors.lastname: Yan
authors.affiliation: Department of Pediatric Orthopedics, Hunan Children's Hospital, Pediatric Academy of University of South China, Changsha City, Changsha, China.
authors.forename: Sheng-Xiang
authors.initials: SX
authors.lastname: Huang
authors.affiliation: Department of Pediatric Orthopedics, Hunan Children's Hospital, Pediatric Academy of University of South China, Changsha City, Changsha, China.
authors.forename: Xiao-Qian
authors.initials: XQ
authors.lastname: Tan
authors.affiliation: Department of Pediatric Orthopedics, Hunan Children's Hospital, Pediatric Academy of University of South China, Changsha City, Changsha, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Lei
mesh_terms: D002648:Child; D005260:Female; D005360:Fibula / Q000002:abnormalities*; D006801:Humans; D015994:Incidence; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D011542:Pseudarthrosis / Q000151:congenital* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D013977:Tibia / Q000002:abnormalities*
keywords: bone lesion; complication; congenital pseudarthrosis of the tibia; fibula status; pseudarthrosis