A free vascularized fibular graft was used to treat a case of congenital pseudoarthrosis of the tibia in a 5-year-old girl. Four weeks after the surgery, x-ray films revealed remarkable callus formation at the proximal junction of the graft and tibia. Seventeen months passed before union at this junction was completed. Union at the distal junction, on the other hand, took only 12 weeks. It was noted that the fibular graft enlarged in diameter rapidly, and at 17 months was the same size as the recipient tibia.
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