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目的 探讨儿童先天性胫骨假关节实现初期愈合后不同腓骨状态与再骨折、踝外翻等并发症之间的关系.方法 回顾性分析我科2007至2011年收治的59例Crawford Ⅳ型先天性胫骨假关节患儿,根据先天性胫骨假关节(congenital pseudarthrosis of tibia,CPT)实现初期愈合后的腓骨状态,将其分为CPT伴腓骨假关节组(A组)、CPT伴腓骨完整组(B组),比较这两组患儿的再骨折、踝外翻、胫骨外翻、肢体不等长的发生情况.结果 A组中有14例患儿发生再骨折,再骨折发生率为36.8％,30例患儿发生踝外翻,踝外翻发生率为78.9％,踝外翻Malhotra分级,0级:8例,Ⅰ级:15例,Ⅱ级:3例,Ⅲ级:12例.27例患儿发生胫骨外翻,胫骨外翻发生率为71％,胫骨平均外翻7°(5°～20°).24例患儿存在肢体不等长,肢体不等长发生率为63.2％,平均肢体不等长1.26 cm (0.6～4.4cm).B组中有2例患儿发生再骨折,再骨折发生率为9.5％,11例患儿发生踝外翻,踝外翻发生率为52.4％,踝外翻Malhotra分级,0级:10例,Ⅰ级:6例,Ⅱ级;3例,Ⅲ级:2例.8例患儿发生胫骨外翻,胫骨外翻发生率为42.9％,胫骨平均外翻2.9°(5°～13°).13例患儿存在肢体不等长,肢体不等长发生率为61.9％,平均肢体不等长1.48 cm (0.5～5 cm).A组的再骨折和踝外翻发生率比B组要高,差异有统计学意义(P＜0.05).结论 CPT患儿实现初期愈合后伴有腓骨假关节者,其再骨折、踝外翻发生率高.CPT的治疗应该重视腓骨假关节的治疗.“,”Objective To explore the relationship of postoperative complications and fibula integrity in congenital pseudarthrosis of the tibia (CPT) in children.Methods A retrospective study was conducted for examining the relationship of postoperative complications and fibula integrity with CPT in children.Between 2007 and 2011,59 surgical patients with Crawford Ⅳ CPT were divided into 2 groups of CPT with fibular pseudarthrosis (group A) and CPT with fibula intact group (group B) according to fibula status after primary tibial union.The inter-group incidence was compared for refracture,ankle valgus,tibial valgus and limb length discrepancy.Results In group A,14 (36.8％) cases had re-fracture.Among 30 (78.9％) cases,the grade of ankle valgus was 0 (n =8),Ⅰ (n =15),Ⅱ (n =3) and Ⅲ (n =12).And 27(71％) cases of tibial valgus had an average angle of 7 ° (5°-20 °);24 (63.2％) cases of limb length discrepancy had an average limb length of 1.26 (0.6-4.4) cm.In group B,2 (9.5％) cases had re-fracture,11 (52.4％) cases of ankle valgus had the grades of 0 (n =10),Ⅰ(n =6),Ⅱ (n =3) and Ⅲ (n =2);8(42.9％) cases of tibial valgus had an average angle of 2.9° (5°-13°);13 (61.9％) cases of limb length discrepancy had an average limb length of 1.48 cm (0.5-5).Significant inter-group differences existed in refracture and ankle valgus (P＜0.05).Conclusions After primary union of CPT,fibular pseudarthrosis has a higher incidence of re-fracture and ankle valgus.