228VASCULARIZED FIBULAR GRAFTING FOR CONGENITAL TIBIAL PSEUDOARTHROSIS: PROMISING OUTCOMESCongenital pseudoarthrosis of the tibia (CPT) poses a challenging treatment dilemma. This study investigates the use of vascularized fibular grafting (VFG) in addressing CPT in a cohort of eight patients, comprising five females and three males. The recipients' mean age undergoing VFG was 7.1 years (range: 1.8 to 11.6 years), with a follow-up period averaging 11.8 years (range: 4.8 to 19.7 years). Five patients had previously undergone multiple surgeries, while three had no prior surgical interventions. Successful bone consolidation was achieved within an average of 6.7 months across all cases. Seven cases achieved consolidation after the initial VFG, while one required a second procedure. Patients with a history of multiple surgeries exhibited a more significant leg length discrepancy (average: 7.6 cm) compared to those without prior interventions (average: 0.8 cm). The findings highlight VFG as a promising primary treatment for CPT, especially in cases without prior surgical interventions, yielding favorable long-term outcomesDr Kale Rohith Vasant@gmail.comResearch1122021 Congenital Pseudoarthrosis tibia, VFG, Leg Length, Fibular GraftsDr Gautham chowhan M, Dr Kale Rohit vasantAssistant Professor, Department of Orthopaedics, Gayatri Vidya parishad Institute of health care & medical technology, Madhurawada, Visakhapatnam, India