Canal Restoration Research Articles

Motivating residents to volunteer for urban waterway restoration: A segmentation approach

AbstractUrban landscapes play a crucial role in the health of freshwater ecosystems. The task of protecting and restoring urban freshwater waterways requires concerted efforts from all sectors of society, including volunteers. The recruitment and retention of volunteers is often a challenge for community environmental organizations as urban residents are diverse and influenced by a blend of personal, societal, and environmental factors. We surveyed a representative sample of 1901 urban residents across Aotearoa New Zealand and used the Behaviour Change Wheel framework and audience segmentation to understand the underlying factors influencing volunteering for waterway restoration projects and to identify potential target audiences to recruit new volunteers. We identified four segments within the target audience (“Supportive,” “Receptive but unsure,” “Hesitant and lack opportunity,” and “Reluctant”) each with its own unique profile of capabilities, opportunities, and motivations for volunteering. Recommendations for appropriate intervention designs to increase levels of volunteering include providing tailored messaging and events for those who are “Receptive but unsure” or “Hesitant and lack opportunity” and information about volunteering opportunities to “Supportive” individuals. This knowledge lays the groundwork for future initiatives focused on increasing urbanites' volunteering with community freshwater restoration groups.

Re-naturing cities through water-centric development: evaluating a canal restoration project in Narayanganj City, Bangladesh

AbstractThe concept of ‘re-naturing cities’ promotes nature-based solutions for sustainable urban design; one of those being water-centric development with networks of blue (water bodies) and green (vegetation areas) aims to generate urban areas that support economic growth, strengthen social cohesion, and restore degraded ecosystems. Projects get implemented for revitalizing urban water bodies with multifunctional areas. This context demands to study water-centric development projects for evaluating the success of ‘re-naturing cities’ in terms of achieving sustainable goals. This research analyzes a part of a canal restoration project of Narayanganj City, Bangladesh, for investigating the development process and understanding its effectiveness in achieving sustainable goals. The study employs multiple qualitative tools for capturing users' views (emic analysis) and researchers' views (etic analysis). The combined understanding identifies that the project focuses primarily on adding an aesthetically pleasing element to the urban fabric, overlooking multiple socioeconomic and ecological possibilities of living with water.

The role of numerical model in assessing the waterway restoration for watershed management, the case of BAHR YOUSSEF, Egypt

In this study, the role of the numerical models in the river restoration project is discussed. The government of Egypt has a national strategic plan seeking to increase the cultivated area throughout the whole country. This will result in greater water demand for the irrigation sector, which brings attention to the water streams and their existing capacity to carry the new water discharge. Within this national plan, the Ministry of Water Resources and Irrigation intends to increase the discharge capacity of Bahr Youssef waterway from 15 million to 18 million m3/day to cope with the new development projects and the increased population density. Therefore, this work aims to provide the methodology to raise the capacity of Bahr Youssef Waterway to carry the required discharge with least cost. The SOBEK-1D numerical model was used in investigating different rehabilitation scenarios to enhance the waterway capacity to carry 18 million m3/day. The evaluation of the different alternatives considered the socioeconomic aspect as well as the technical and financial aspects. Many settlements exist on the canal bank with different activities depending on the water supplied from Bahr Yousef. The study concluded that it is possible to pass 18 million m3/day in Bahr Youssef. The model results illustrate that this could be happen by dredging only approximately 5,988,684 m3 of sedimentation in the four reaches instead of dredging the whole entire canal with a quantity of 21,150,000 m3. The model succeeded to reduce the required dredging volume by about ¾ of the total deposited material. The model results recommended to dredge only 103.1 km which is about 1/3 of the total length of the whole waterway path, which is approximately 293 km. This resulted in a reduction of the project estimated cost by approximately 72%, with the final dredging cost of approximately 239.5 million EGP for the selected areas.

Enhancing Urban Stream Values: The Case of the Cooks and Georges River Catchments

Waterway restoration in urban areas can be an important environmental policy topic. However, there have been few studies of monetary benefits to help justify expenditures and inform priority setting for remediation works. We investigated values for improving river health in two catchments in Sydney, Australia: the Cooks Catchment, which is smaller and urban-based, and the Georges Catchment, which is larger and located in both urban and periurban areas. Using choice experiments, we found that households are willing to pay Australian Dollars (AUD) 10.34 per year for 5 years in the Cooks Catchment, and AUD 2.64 in the Georges Catchment, to restore 1 km of urban waterway. We found that willingness to pay is moderated by the time until project outcomes are achieved. Comparison with typical costs of urban stream remediation suggested that there is a broad range of projects that will produce positive net benefits in the Cooks Catchment, whereas in the Georges Catchment the economically viable projects are those with lower cost and that can achieve their outcomes relatively quickly.

Hydrodynamic Modeling of Inundation Patterns of a Large African Floodplain Indicates Sensitivity to Waterway Restoration

AbstractLarge‐scale floodplains are important features of the African continent. Regular inundation provides the means to support large populations but can also present problems such as access to health facilities and water body formation that sustain malaria vectors. Modeling of these floodplains is therefore important, but complex. In this research, we develop, calibrate, and validate a hydrodynamic model of the Barotse Floodplain, of the Upper Zambezi, Zambia. The floodplain has seen recent infrastructure developments including the restoration of the canal network and construction of a cross floodplain causeway. In order to create a robust model, a multiobjective calibration uses a time slice approach based on available Landsat satellite image overpasses. An emulator‐based sensitivity analysis indicates the significance of hydrological processes in the model. Model evaluation is undertaken for two events in the gauge record (2009 and 2018), of similar magnitude that occur before and after modifications to the floodplain. Results indicate a complex impact of infrastructure development on the hydrodynamics of the floodplain, with a higher peak flow, but with a redistribution of water throughout the floodplain. Deeper flooding is observed in some areas while others experience lower water levels. The sensitivity results also reflect a change in processes, where floodplain flows dominate the 2009 event, whilst channel process dominate the 2018 event. Overall, we show that relatively modest modifications to the floodplain have impacted flood water levels, which in turn will influence access route availability and alter malaria transmission rates.

Restoration as world-making and repair: A pragmatist agenda

The UN’s Decade of Ecosystem Restoration commenced in June 2021, with the expectation that ecological restoration will be vastly scaled-up internationally. Millions of hectares of the earth’s surface is projected to be restored, from forests and peatland to rivers, reefs and grasslands. This will transform restoration from a predominantly localized, community-driven field to a highly capitalized, professional activity. As the renowned biologist E. O. Wilson proposed, the twenty-first century certainly does look likely to be characterized by restoration. And yet, thus far, the still emerging field of ecological restoration has been dominated by the natural sciences, in both theory and practice, neglecting broader questions of how to live in and with restored landscapes. This paper contends that if restoration is to be significantly expanded over the next decade, the social sciences and humanities must be involved to ensure its purpose is given adequate scrutiny, by engaging wider publics of interest in scheme planning, design and implementation. This is crucial given the dominance of natural capital accounting in restoration, which privileges economic reasoning over alternative, more radical forms. Pragmatism, which has a substantive philosophical interest in the relationship between humans and their environment, can offer a distinctive orientation to inquiry conducive to collaboration between the natural and social disciplines. Focusing on waterway restoration in the United Kingdom, and drawing on social and natural science literature, this paper outlines a pragmatist research agenda that recognizes multiplicity in nature, advocates experimentation in human-environment relations, and foregrounds community in democratic renewal. The paper considers not only ways that pragmatism can inform restoration but how restoration can advance a pragmatist agenda for invigorating public life. This encourages scholars to think with not only against restoration, attending to composition as well as critique, as part of a political urban ecology.

Surgical Intervention is Associated With Improvements in the ASIA Impairment Scale in Gunshot-induced Spinal Injuries of the Thoracic and Lumbar Spine.

Retrospective cohort study of patients from the National Spinal Cord Injury Statistical Center (NSCISC). The aim was to compare the outcomes of patients with gunshot-induced spinal injuries (GSIs) treated operatively and nonoperatively. The treatment of neurological deficits associated with gunshot wounds to the spine has been controversial. Treatment has varied widely, ranging from nonoperative to aggressive surgery. Patient demographics, clinical information, and outcomes were extracted. Surgical intervention was defined as a "laminectomy, neural canal restoration, open reduction, spinal fusion, or internal fixation of the spine." The primary outcome was the American Spinal Injury Association (ASIA) Impairment Scale. Statistical comparisons of baseline demographics and neurological outcomes between operative and nonoperative cohorts were performed. In total, 961 patients with GSI and at least 1-year follow-up were identified from 1975 to 2015. The majority of patients were Black/African American (55.6%), male (89.7%), and 15-29 years old (73.8%). Of those treated surgically (19.7% of all patients), 34.2% had improvement in their ASIA Impairment Scale score at 1 year, compared with 20.6% treated nonoperatively. Overall, surgery was associated with a 2.0 [95% confidence interval (CI): 1.4-2.8] times greater likelihood of ASIA Impairment Scale improvement at 1 year. Specifically, benefit was seen in thoracic (odds ratio: 2.5; 95% CI: 1.4-4.6) and lumbar injuries (odds ratio: 1.7; 95% CI: 1.1-3.1), but not cervical injuries. While surgical indications are always determined on an individualized basis, in our review of GSIs, surgical intervention was associated with a greater likelihood of neurological recovery. Specifically, patients with thoracic and lumbar GSIs had a 2.5 and 1.7-times greater likelihood of improvement in their ASIA Impairment Scale score 1 year after injury, respectively, if they underwent surgical intervention.

Riparian plant species offer a range of organic resources to stream invertebrate communities through varied leaf breakdown rates

ABSTRACT Riparian plants provide an important source of energy for freshwater food webs through inputs of leaf litter. Planting riparian buffers with mixed species could enhance the detrital resource supply for invertebrates through varied leaf breakdown rates. To quantify leaf breakdown rates and invertebrate colonisation, we used leaves from eleven grass, shrub and tree species common along agricultural waterways in New Zealand. Breakdown of leaves immersed in a spring-fed stream differed significantly among species, being fastest for pasture grass (k = 0.0458 day−1) followed by broadleaf, pittosporum, willow, toetoe, poplar, gorse, Carex, eucalyptus, flax, and slowest for cabbage tree leaves (k = 0.0099 day−1). Invertebrate community composition did not differ between leaf species, but consumers were extremely abundant on some leaves (e.g. 51–83 Potamopyrgus snails g−1 pasture grass), indicating coarse detrital resources were in high demand for food or habitat. These breakdown rates could inform selection of riparian plant combinations that will enhance food availability for stream communities, especially continuity of supply, thereby contributing to waterway restoration.

Valuing the Environmental Benefits of Canals and Canal Restoration Using House Prices

This paper values the local environmental benefits of historic, navigable canals using property values. We employ regressions on high-volume transaction data, controlling for micro-geographic fixed effects, and cross-check these estimates against a causal, difference-in-differences analysis of a local canal restoration project. We find a price premium within 100 m, suggesting benefits for canal-side properties with a direct outlook or immediate access, around 5% before the 2008 recession, falling to 3.4% by 2016. These locations have a higher proportion of new-build sales, suggesting they attract developers. Our calculations imply canals generate land value uplift of £0.8-0.9 billion in England and Wales.

Regional relationships for bankfull hydraulic geometry and discharge in the southern Andes of Ecuador: An application in the estimation of geomorphological runoff thresholds

The bankfull represents the boundary between the processes taking place in the canal and the floodplain. The geometry of the bankfull is highly correlated with the drainage area, making it possible to establish regional bankfull geometry relationships that have wide application in canal restoration, studies of river bed degradation, dimensioning of infrastructure, hydrological modeling, among others. In this study, the regional bankfull geometry relationships were determined for an Andean zone in southern Ecuador, getting coefficients comparable to those reported in literature determined in other mountainous areas of the continent. Correlation coefficients higher than 0.60 were obtained, considered statistically significant. The geomorphological runoff threshold, which represents the effective amount of rainfall needed to produce bankfull discharges, was determined using regional bankfull geometry relationships, geomorphological characteristics of the drainage basins in the study area, and the NRCS unit hydrograph. The geomorphological runoff threshold varies from 0.8 mm to 8.50 mm and is based on the concept of the unit hydrograph; therefore it presents the same application limitations and uncertainties associated with the determination of the characteristics of the basin, the bankfull and the scale of work. Future works are proposed considering more detailed scales, a greater number of observation sites and the inclusion of additional variables of the drainage area such as slope, aspect and precipitation, to improve the estimates.

256. Surgical intervention is associated with improvements in the ASIA impairment scale in gunshot induced spinal injuries of the thoracic and lumbar spine

<h3>BACKGROUND CONTEXT</h3> Spinal injuries are relatively common injuries that have a lasting impact on patients and are a significant cause of disability. Gunshot induced spinal injuries (GSIs) are the third most common cause of spinal injury and are increasing in proportion. Despite the severity and frequency of these injuries, there remains a lack of conclusive evidence regarding the optimal management of patients with GSIs. <h3>PURPOSE</h3> We aimed to better understand the impact of surgical intervention in patients who sustained gunshot induced spinal injuries. <h3>STUDY DESIGN/SETTING</h3> Retrospective comparative study. <h3>PATIENT SAMPLE</h3> Patients in the National Spinal Cord Injury Statistical Center (NSCISC) database with GSIs and complete one-year follow-up information. (n = 961) <h3>OUTCOME MEASURES</h3> The primary outcome measure was defined as improvement in ASIA Impairment Scale from the time of presentation. <h3>METHODS</h3> Patient demographics, clinical information, and outcome data were extracted from the NSCISC database. Surgical intervention was defined as any procedure involving a laminectomy, neural canal restoration, open reduction, spinal fusion, or internal fixation of the spine. Functional assessments included the American Spinal Injury Association (ASIA) Impairment scale. Bivariate analysis as well as multivariate analysis was performed. <h3>RESULTS</h3> A total of 961 patients with GSI and one-year follow-up were identified from 1975-2016. The majority of patients were Black/African American (55.6%), male (89.7%), and aged 15-29 (73.8%). Of those who underwent surgical intervention, 34.2% had an improvement in their ASIA Impairment Scale at one year as compared to 20.6% of those treated non-operatively. Overall, surgery was associated with 2.0 [95% CI 1.4 - 2.8] times greater likelihood of ASIA Impairment Scale improvement at one year. Specifically, benefit was seen in thoracic (OR 2.5 [95% CI 1.4-4.6]) and lumbar injuries (OR 1.7 [95% CI 1.1-3.1]), but not cervical injuries. At 5-year follow-up, surgery was associated with 6.2 [95% CI 1.4-16.0] times greater likelihood of improvement in the ASIA Impairment Scale. <h3>CONCLUSIONS</h3> While the decision to undergo surgery should be individualized, in our large review of GSIs, surgical intervention was associated with a greater likelihood of neurologic recovery. Specifically, patients with thoracic and lumbar GSI have a 2.5- and 1.7-times, respectively, greater likelihood of improvement in their ASIA Impairment Scale one year after injury if they underwent surgical intervention. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.

Comparative study between a short segment with incorporating screws versus long-segment pedicle-screw fixation in management of unstable thoracolumbar spine fractures

Background Posterior pedicle screw fixation has become a popular method for treating thoracolumbar burst fractures. However, it remains unclear whether additional fixation of more segments could improve clinical and radiological outcomes. Aim and objectives The aim of this study was to evaluate the clinical and radiological outcome of a short segment with incorporating screws versus long-segment posterior stabilization using transpedicular screws for management of unstable thoracolumbar spine fractures. Patients and methods This was a prospective retrospective comparative clinical trial with 20 patients’ short segment with incorporating screws and long-segment fixation in another 20 patients. The duration of the study ranged from 6 to 12 months. Results There is a significant difference between the two studied groups as regards angle correction; however, there is a significant reduction in angle correction in both groups: group A more than group B, and there is a significant difference between the two studied groups regarding complications that were more frequent in group B. Conclusion Short-segment fixation (including the fractured vertebrae) in the thoracolumbar region is as effective as the long segment with good spinal canal restoration and correction of kyphotic angle and may enhance the regaining of neurological function although better results were achieved radiologically by long-segment fixation while clinically they are the same results.

Food Security in COVID‐19: Insights from Indigenous Fijian Communities

Food Security in <scp>COVID</scp>‐19: Insights from Indigenous Fijian Communities

Broaching the brook: Daylighting, community and the ‘stickiness’ of water

Over the last century, under the modern hydraulic model, waterways across the world have been heavily canalized and culverted, driven into underground pipes, drains and sewers. This hydraulic approach has hardwired an isolated water network into the urban fabric, fragmenting erstwhile patterns and dynamics of life, both human and nonhuman. Ecologically, it has been hugely damaging, reducing water quality and biotic diversity, but also socially, disconnecting citizens from the waterways that service and characterize the city. Consequently, since the 1990s, waterway restoration has become widespread as a design solution to degraded rivers and streams, reinstating compromised hydrological, geomorphological and ecological processes. Deculverting or ‘daylighting’, the focus of this paper, is a radical form of restoration, opening up subterranean, culverted waterways often forgotten by communities above ground. Yet, as this paper emphasizes, waterway restoration has tended to privilege ecological over social objectives, while public engagement in project conceptualization has been limited, conducted ‘downstream’ subsequent to planning and design stages. Restoration schemes have therefore tended to reflect the concerns of professionals rather than communities, overlooking their potential for social renewal and change. Drawing on workshop data collected through participatory mapping exercises, this paper explores the case for daylighting a culverted brook in Urmston, Greater Manchester, focusing in particular on the preferences, concerns and knowledge of local residents. The paper compares professional and community perspectives on the preferred scheme design and potential benefits of daylighting, drawing out differences and tensions between them, temporarily ‘unblackboxing’ the brook. It is ventured that daylighting can unleash the social ‘stickiness’ of water, its proclivity to draw and bind together, to revitalize the park, enhancing connection to wildness, attachment to place and sense of community. This is particularly crucial in the face of decreased local authority funding and related crises in park management.

Quantifying links between instream woody habitat and freshwater fish species in south‐eastern Australia to inform waterway restoration

Abstract Removal of instream woody habitat (IWH) is one factor attributed to declines in fish populations worldwide. Restoration of IWH to help fish populations recover is now common; however, quantitative predictions about the outcomes of these interventions is rare. As such, quantitative links between IWH and fish abundance is of interest to managers to inform conservation and restoration activities. Links between instream habitat attributes, especially IWH, and selected fish species of recreational, cultural, and ecological significance were explored at 335 sites spanning eight streams across south‐eastern Australia. Data were collected on fish abundance and length, IWH density and a range of other habitat attributes at a scale that incorporated at least one of each of the major mesohabitat types (functional river elements). The data were analysed using Bayesian hierarchical generalized linear mixed models to examine fish habitat associations and used to make quantitative predictions of responses to future restoration. Strong positive relationships were found between fish abundance and IWH density and the strength of this relationship varied between species and waterways. Murray cod (Maccullochella peelii), a species commonly targeted by IWH interventions, displayed the strongest association with IWH density. River blackfish (Gadopsis marmoratus) also showed a significant relationship with IWH, but this effect was waterway specific. Fish length was only related to IWH for river blackfish. These results may reflect differences in the life histories of these two species. We suggest that differences in habitat association through ontogeny may be more relevant at smaller spatial scales. The results generated in this study can be used to guide waterway restoration and develop quantitative predictions about how fish might respond to IWH interventions across south‐eastern Australia. This approach provides a powerful quantitative framework within which to explore management options and objectives, and to test our predicted responses to habitat restoration.

The Terrestrialization of Amphibious Life in a Danube Delta 'Town on Water'

The Danube Delta town of Vilkovo is often called the ‘Ukrainian Venice’ because of its 40 kilometers of canals. Many of these canals, however, are rapidly filling in with silt and are often impassible by boat. Tourism entrepreneurs and town administrators have begun lobbying for funding for a large-scale canal restoration project and for the town’s designation as a heritage site. Their tourism-development narratives, however, often overlook or simplify a complex set of social and environmental factors that have shaped residents’ past and present relationships with the Danube River. This article counters this tendency by providing an ethnographic portrait of terrestrialization—a term I use to name the confluence of geomorphological, ecological and social change in Vilkovo—that draws on townspeople’s descriptions of their dwelling practices. It combines insights from amphibious anthropology and social science literature on water infrastructure in order to pinpoint issues that need to be addressed in developing the town’s tourist economy, and makes the case for including studies of terrestrialization as part of an amphibious anthropology.

The Effect of Cold Atmospheric Plasma (CAP) Treatment at the Adhesive-Root Dentin Interface.

To investigate the use of a cold atmospheric plasma (CAP) source in a clinically realistic endodontic procedure to enhance the bond strength of a dental adhesive in root canal restoration. CAP was generated by a handheld DBD-jet prototype specifically designed for biomedical applications. Extracted monoradicular teeth were standardized through crown sectioning and root canal shaping before being embedded in epoxy resin cylinders using a custom molding procedure designed to ensure the accurate alignment of the specimens. Afterwards, the dentin surface was conditioned according to different protocols including (or not, in controls) chelating agents (EDTA or IP6) and CAP treatment (180 s). Then a self-etch adhesive was applied, followed by a luting material to seal the root canal. Both materials were light cured. Tooth sections were obtained from coronal and middle portions of the root canal, and the push-out test was used to evaluate the bond strength between the adhesive and dentin. Push-out results demonstrated that plasma treatment greatly improved (> twofold) the mechanical properties of the adhesive-dentin interface along the whole length of the root canal. Contact angle measurements and SEM analyses showed that plasma treatment facilitated adhesive permeation into dentinal tubules, hence enhancing the effects of the bonding procedure. Although investigations on long-term bond stability after CAP treatment and clinical studies are required, the present study indicates that CAP devices may be useful in clinical endodontic treatment.

A multi-functional and multi-compartment constructed wetland to support urban waterway restoration

Abstract This study assessed the significance of a multi-functional and multi-compartment constructed wetland (CW) implemented to restore a degraded urban waterway in Western Australia. The wetland was initially constructed as a surface flow system, then modified through the incorporation of the additional laterite-based subsurface flow system, with the potential for operation of a recirculation scheme and groundwater top-up during low water flows in summer. The CW performance was assessed by comparing nitrogen (N) and phosphorus (P) attenuation during base flow, high flow and episodic storm flow conditions. The performance varied from approximately 41% total nitrogen (TN) and 66% total phosphorus (TP) loads reduction during storm events, increasing up to 62% TN and 99% TP during low flow and summer recirculation periods. In overall, the CW attenuated about 45% TN and 65% TP loads from being delivered to the downstream sensitive river between 2009 and 2015. The CW design proved to be not only highly effective at reducing nutrient loads, but also improved the ecological services of the urban waterway by providing a diverse area for habitat and recreational activities.

PENATALAKSANAAN NEKROSIS PULPA DISERTAI LESI PERIAPIKAL PADA GIGI 47

Root canal treatment is divided into 3 stages, namely the biomechanical preparation stage of the root canal, the sterilization and disinfection stage of the root canal, and the root canal filling stage. The success of root canal filling depends on the state of asepsis, thorough cleaning of the pulp tissue, biomechanical preparation, and hermetic root canal filling. After root canal treatment, teeth require different treatment than vital teeth, due to reduced moisture in these teeth and a reduction in dentin during the root canal preparation process, which affects the remaining hard tissue structure of the teeth. There are several types of restorations that can be used after root canal treatment. Post-root canal restoration treatment using composite resin materials can be made directly or indirectly, the technique must be able to strengthen the remaining hard tissue structure of the teeth and restore tooth function. If some of the teeth are missing but still have sufficient thickness of the dentin enamel structure and the patient wants a tooth-colored restoration, indirect composite onlay may be an option.

Fibular donor site following non vascularized harvest: clinico-radiological outcome at minimal five year follow-up.

The long-term donor site outcome of non vascularized fibular harvest in paediatric age group is not well studied. We evaluated clinical and radiological characteristics of fibular harvest site in children at a minimum five year follow-up. The patients with donor legs underwent both physical and radiographic examination. Clinical parameters evaluated were pain, neuromuscular weakness, and standing tibiocalcaneal hindfoot valgus in the donor limb. Radiologically, longitudinal non continuity in regeneration, medullary canal reformation, Malhotra grading, and lateral distal tibial angle (LDTA) were documented. Sixteen patients (18 legs) were available for follow-up. The average follow-up was 6.23 ± 1.1years. None of the patients reported pain or neuromuscular weakness related to the donor leg. Five patients reported cosmesis issues related to exaggerated ankle valgus. Medullary canal restoration was seen in 3/14 regenerated fibulae. Harvested legs had overall higher fibular station than contralateral unintervened ankles. Non continuity in regeneration were seen in 4/18 legs. There was clinical hindfoot valgus, abnormal LDTA, and fibular station in these patients. Clinical valgus matched better with a combination of fibular station and LDTA (83.3%) rather than fibular station or LDTA (75%) alone. Fibular regeneration was complete in more than 75% legs at follow-up of > fiveyears but remodeling and reformation of medullary canal was delayed. Long-term fibular non regeneration was persistently responsible for development of ankle valgus deformity. Middle lower third fibular junction is critical area for non restoration of medullary canal and non continuity.