Outcome of distal clavicular fracture separations and dislocations in immature skeleton.

Background: There are only a few studies with long-term follow-up of distal clavicular injuries in children and their treatment is not clearly defined. The purpose of our study is to suggest a new classification system according to the fracture pattern and the degree of the displacement, to evaluate the long-term follow-up and also to propose an algorithm for treatment.

Methods: We conducted a retrospective study from 1983 to 2008.

Long-term follow-up of combined fractures of the proximal radius and ulna during childhood.

Forty-five children with combined fractures of the proximal end of the radius and ulna were treated in our orthopedic department over a period of 16 years (1984-1999). The age of the patients ranged from 5 to 12 years (mean 8 years) with a peak of 7-8 years. The mechanism of injury was a fall on the outstretched hand with the elbow extended and with a valgus force being applied to the elbow.

Chronic osteomyelitis of the pelvis in children and adolescents.

Osteomyelitis of the pelvis is rare in children as well as in adults. This explains why the diagnosis is often missed, so that the infection becomes chronic. The authors report five chronic paediatric cases, seen between 1993 and 2003.

Elongation of the femoral neck in Perthes disease.

We present the long-term clinical and radiological results of a series of 168 young patients with unilateral Perthes disease who were treated in our department between 1989 and 1997, using a combined osteotomy in the longitudinal and horizontal axis of the proximal femur and elongation of the femoral neck. Surgical treatment was undertaken for any group II (Catterall's classification) patient, with the presence of two or more radiographic signs of the "head at risk" and the clinical sign of flexion with abduction, as well as for all cases classified by Catterall as groups III and IV. The surgical procedure we describe provided 147 radiologically and clinically normal hips in the short and long-term.

Outcome of physeal and epiphyseal injuries of the distal tibia with intra-articular involvement.

The authors reviewed 83 physeal and epiphyseal injuries of the distal tibia with intra-articular involvement. The children, aged 11 to 14 years, were treated in the authors' department during 1987 to 1999. Treatment was nonoperative for 72.

Talus fracture associated with a fracture dislocation of the distal tibia in an immature skeleton.

A 12-year-old boy with a severe injury of his right ankle was treated in the accident unit. The local condition was an extensive open wound with parts of the fractured bones prominent. Radiographs showed a severely displaced fracture of the body of the talus associated with a Salter-Harris IV injury of the distal tibia and subluxation of the ankle.