Anil Agarwal1,2, Deepak Kumar3, Nargesh Agrawal3, Neeraj Gupta3. 1. Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, 110031, India. rachna_anila@yahoo.co.in. 2. , 4/103, East End Apartments, MayurVihar Ph-1 Ext, Delhi, 110096, India. rachna_anila@yahoo.co.in. 3. Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, 110031, India.
Abstract
BACKGROUND: The literature on ankle valgus development after procuring non-vascularised fibular grafts in children is still scanty. The non-vascularised fibular graft has distinction of fibular regeneration occurring at the donor site. MATERIAL AND METHODS: We retrospectively analysed the valgus deformities at the donor leg following harvest of non-vascularised fibular graft to determine the various contributing factors in growing children. All these patients had minimum two years post index procedure follow up. The radiological ankle valgus was quantified using Malhotra's distal fibular station (0-3), Lateral distal tibial angle (LDTA <84 degrees) and Talar tilt angle >5 degrees. Clinical parameters, evaluated additionally were pain and neuromuscular deficits in the donor limb, if any. RESULTS: A total of 30 ankles in 23 patients were evaluated. The average patient age was 9.56 years. There was no pain or neuromuscular deficit in the examined limbs at a mean follow up of 39.4 months. The continuity of the fibula in the longitudinal dimension was already restored in 90% limbs. There was presence of radiological valgus deformity in 10 (33%) ankles. The LDTA was abnormal in 80% and talar tilt in 50% valgus ankles. The ankle valgus deformity was found despite the presence of a normal Malhotra station 0. The age of the patient did not seem to influence the ankle valgus deformity. CONCLUSIONS: Radiological ankle valgus is a common occurrence even following non-vascularised fibular harvest. The presence of a regenerated fibula in continuity (90% legs) and almost of similar anatomical longitudinal dimensions (97%) did not deter development of valgus deformity at ankle.
BACKGROUND: The literature on ankle valgus development after procuring non-vascularised fibular grafts in children is still scanty. The non-vascularised fibular graft has distinction of fibular regeneration occurring at the donor site. MATERIAL AND METHODS: We retrospectively analysed the valgus deformities at the donor leg following harvest of non-vascularised fibular graft to determine the various contributing factors in growing children. All these patients had minimum two years post index procedure follow up. The radiological ankle valgus was quantified using Malhotra's distal fibular station (0-3), Lateral distal tibial angle (LDTA <84 degrees) and Talar tilt angle >5 degrees. Clinical parameters, evaluated additionally were pain and neuromuscular deficits in the donor limb, if any. RESULTS: A total of 30 ankles in 23 patients were evaluated. The average patient age was 9.56 years. There was no pain or neuromuscular deficit in the examined limbs at a mean follow up of 39.4 months. The continuity of the fibula in the longitudinal dimension was already restored in 90% limbs. There was presence of radiological valgus deformity in 10 (33%) ankles. The LDTA was abnormal in 80% and talar tilt in 50% valgus ankles. The ankle valgus deformity was found despite the presence of a normal Malhotra station 0. The age of the patient did not seem to influence the ankle valgus deformity. CONCLUSIONS: Radiological ankle valgus is a common occurrence even following non-vascularised fibular harvest. The presence of a regenerated fibula in continuity (90% legs) and almost of similar anatomical longitudinal dimensions (97%) did not deter development of valgus deformity at ankle.
Authors: Abdul Razak Sulaiman; Zulmi Wan; Shukrimi Awang; Aminudin Che Ahmad; Ahmad Sukari Halim; Rajaei Ahmad Mohd Zain Journal: J Pediatr Orthop B Date: 2015-09 Impact factor: 1.041
Authors: Pedro González-Herranz; Angel del Río; Jesús Burgos; Jose A López-Mondejar; José María Rapariz Journal: J Pediatr Orthop Date: 2003 Jan-Feb Impact factor: 2.324
Authors: Gerard A Sheridan; John T Cassidy; Aaron Donnelly; Maria Noonan; Paula M Kelly; David P Moore Journal: Strategies Trauma Limb Reconstr Date: 2020 May-Aug