Abstract： 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.