Predictable regeneration and protective effect against ankle valgus following non-vascularized fibular graft harvest in children

doi:10.5312/wjo.124681

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World Journal of Orthopedics

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2218-5836

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Orthop. Aug 18, 2026; 17(8): 124681
Published online Aug 18, 2026. doi: 10.5312/wjo.124681

Table 1 Summary of findings of the study, n (%)

Total number of cases	16
Total number of fibulae harvested	27
Mean age	6.1 years (SD = 2.8 years; range 35-11.5 years)
Mean follow-up	25.8 months (SD = 17.9 months; range 6-72 months)
Male:Female	10:6
Unilateral:Bilateral	5:11
Mean LDTA
Preoperative	89.1 degrees (SD = 3.1 degrees)
6 months	87.8 degrees (SD = 2.8 degrees)
Final follow-up	86.6 degrees (SD = 2.8 degrees)
Malhotra grade
Preoperative	Grade 0: 9; grade 1: 18; grade 2: 0; grade 3: 0
6 months	Grade 0: 2; grade 1: 19; grade 2: 6; grade 3: 0
Final follow-up	Grade 0: 5; grade 1: 18; grade 2: 3; grade 3: 1
Complete regeneration
3 months	9 (33.3)
6 months	17 (63)
Final follow-up	21 (77.8)
Incomplete regeneration	6 (22.2)

LDTA: Lateral distal tibial angle.

Full Size Table

Table 2 Association between fibular regeneration and development of ankle valgus following non-vascularized fibular graft harvest in children at 6 months and final follow-up

Fibula regeneration	Ankle valgus present	Ankle valgus absent	Odd ratio (95%CI)	P value¹
At 6 months
Present	5	12	0.18 (0.03-0.99)	0.040
Absent	7	3	0.18 (0.03-0.99)	0.040
At final follow-up
Present	7	14	0.10 (0.01-1.03)	0.030
Absent	5	1	0.10 (0.01-1.03)	0.030

¹Pearson χ² test.

Full Size Table

Citation: Iqbal MZ, Agarwal A, Khurana S, Deep A, Sahoo S. Predictable regeneration and protective effect against ankle valgus following non-vascularized fibular graft harvest in children. World J Orthop 2026; 17(8): 124681
URL: https://www.wjgnet.com/2218-5836/full/v17/i8/124681.htm
DOI: https://dx.doi.org/10.5312/wjo.124681

Iqbal MZ, Agarwal A, Khurana S, Deep A, Sahoo S. Predictable regeneration and protective effect against ankle valgus following non-vascularized fibular graft harvest in children. World J Orthop 2026; 17(8): 124681 [DOI: 10.5312/wjo.124681]

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