This study of 75 FFF patients (202 sites) found
that initial osteotomy gap width does not
significantly impact long-term osseous union.
While 86.6% achieved union, fibula–fibula
interfaces and symphyseal locations healed best.
Key determinants of success include systemic
vascular health and fibula morphology rather
than surgical gap precision. Conversely, alcohol
consumption and vascular comorbidities
negatively affect outcomes. 3D-assisted planning
remains vital for complex
