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Donor site changes in early months following nonvascularized fibular harvest in children: a prospective radiological analysis
Journal of Pediatric Orthopaedics B ( IF 1.1 ) Pub Date : 2022-07-01 , DOI: 10.1097/bpb.0000000000000951
Anil Agarwal 1
Affiliation  

The exact timing of non regeneration and ankle valgus in post fibular harvest donor limbs remain elusive. The study examined the serial radiographs post harvest to better understand the transitions occurring in the ankle and leg region. We specifically focused on the noncontinuity of fibular regenerate, lateral distal tibial angle (LDTA), fibular length (fibular/tibial ratio, F/T ratio) and fibular station in the donor leg. Completeness of longitudinal fibular regeneration was documented at 6 months and accordingly two groups, with (R+) and without complete longitudinal regeneration (R−), were available for comparisons. There were 25 fibular harvests in 19 patients. The longitudinal regenerate was complete in 14 limbs (56%) (R+ group) at 6 months. The average LDTA at 6 months did not differ significantly from preoperative values. The F/T ratio decreased immediately postoperative and the trend remained sustained till 6 months. Malhotra grade corresponded inversely to F/T ratio. There was insignificant intra or intergroup affection of LDTA in R+ and R− groups over initial 6 months. The F/T ratio in R+ group recorded a downward trend till 3 months but remained static thereafter. Malhotra grades comparisons between R+ and R− revealed significant differences only at 6 months. Fibular length (F/T ratio) was found to be the critical indicator of regeneration. For the nonregenerates, ratios deteriorated significantly by 3 months. Malhotra station corresponded to changes in fibular length, although it was less quantitative. The secondary changes in lower tibia may not manifest till 6 months.



中文翻译:

儿童非血管化腓骨收获后最初几个月供体部位的变化:前瞻性放射学分析

腓骨收获后供体肢体的非再生和踝外翻的确切时间仍然难以捉摸。该研究检查了收获后的系列射线照片,以更好地了解脚踝和腿部区域发生的转变。我们特别关注腓骨再生的不连续性、胫骨远端外侧角 (LDTA)、腓骨长度(腓骨/胫骨比、F/T 比)和供体腿的腓骨站。在 6 个月时记录了纵向腓骨再生的完整性,因此分为两组,有 (R+) 和没有完全纵向再生(R-),可用于比较。19 名患者进行了 25 次腓骨切除。6 个月时,14 个肢体(56%)(R+ 组)的纵向再生完成。6 个月时的平均 LDTA 与术前值没有显着差异。术后 F/T 比值立即下降,并且该趋势一直持续到 6 个月。Malhotra 等级与 F/T 比率成反比。在最初的 6 个月内,R+ 和 R- 组中 LDTA 的组内或组间影响不显着。R+组的F/T比率在3个月前呈下降趋势,但此后保持不变。R+ 和 R− 之间的 Malhotra 等级比较仅在 6 个月时显示出显着差异。腓骨长度(F/T 比)被发现是再生的关键指标. 对于非再生者,比率显着下降了 3 个月。Malhotra 站对应于腓骨长度的变化,尽管数量较少。下胫骨的继发性变化可能要到 6 个月才会出现。

更新日期:2022-05-31
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