256VASCULARIZED FIBULAR GRAFTING FOR CONGENITAL TIBIAL PSEUDOARTHROSIS: PROMISING OUTCOMESCPT is difficult to treat as it keeps the bone unstable and causes worsening deformity. Many people with NF1 also have neurofibromas. To enhance results, healthcare professionals use methods such as VFG as well as intramedullary or external fixation. Fifteen patients treated with VFG for CPT are analyzed in this study, with some patients having had prior multiple surgeries and others undergoing their first CPT diagnosis. Both male and female puppies, from 1.8 to 11.6 years old, were part of the cohort. The majority of us preferred ipsilateral fibular grafts and only when those failed or could not be used were contralateral grafts used. The vast majority of patients experienced bone union between 5 and 9 months. Only one patient’s bone failed to unite. Individuals with previous surgeries and CPT had what is known as LLD which differed greatly from being nonexistent to 15.8 cm. For patients who have been through several surgeries, both major LLD and ongoing ankle pain were more common, indicating that it is crucial to handle these cases early and thoroughly plan surgical steps.The patient was able to stand and walk again after the surgery. In spite of possible complications like fracture after surgery and improper ankle position, VFG is still a dependable treatment for this condition. Based on our evidence, the VFG method remains reliable and effective in managing juvenile CPT, so follow-up over the long term is critical to recognize and treat any remaining problems. The research adds significant value in developing efficient approaches for treating this condition in surgery.Suryavara@gmail.comResearch922019 Congenital Pseudoarthrosis tibia, VFG, Leg Length, Fibular GraftsDr. Suryavara Prasad BAssociate Professor, Department of Orthopaedics, Tagore Medical College and Hospital, Chennai – 600127, Tamil Nadu, India