BACKGROUND:Internal bone transport using Ilizarov external fixator for management of post traumatic femoral bone loss is a technically demanding procedure that entails many surgical difficulties. Many complications were encountered either intra or post operative. Proper and early management of these complications markedly improves the overall results. METHODS: In the period from January 2011to June 2013, 17 cases of post traumatic femoral bone loss were treated with bone transport using Ilizarov external fixator. All fractures were open, 15 cases were grade IIIb and two cases were grade IIIc according to Gustillo -Anderson classification. The cases included in this study had bone defect more than four cm. The defect was diaphyseal in five cases and metaphyseal diaphyseal in 12 cases with distal intra articular extension in two cases. This procedure was lengthy; to reduce the time of the procedure, all cases were managed either by acute collapse at the fracture site and subsequent limb lengthening or partial collapse of the defect and limb lengthening to achieve limb length equality. RESULTS: In all cases the bone continuity was restored with complete union of the fracture. The complication rate was high but all of them could be dealt with successfully. According to ASAMI scoring system the bone results were higher than functional results in all cases.

Background: Injury to the medial patellofemoral ligament (MPFL) occurs in nearly all cases of traumatic patellar dislocation. Reconstruction of the MFPL is the main treatment of such conditions. Other anatomical abnormalities that predispose to lateral patellar instability should be excluded for successful outcome after isolated MPFL reconstruction. Methods: In the period from June 2012 to January 2015, 18 patients with had recurrent posttraumatic unilateral lateral patellar instability caused by an isolated MPFL tear that was reconstructed with a semitendinosus autograft to reconstruct MPFL. The mean follow-up period was 24 mo. Patients with isolated MPFL tears were carefully chosen through a series of clinical and radiographic workups. The technique was done through a less invasive approach, with the graft fixed to the femur by a bioabsorbable interference screw and to the patella; the graft was passed through two transverse tunnels making a laterally based loop. Results: No dislocations or apprehension was recorded. Furthermore, there were no major complications, only persistent patellofemoral pain in patients with preoperative osteochondral patellar injuries. Kujala functional score improved from 35.6 preoperatively to 90.4. Conclusions: Careful patient selection and proper surgical technique are the two main items for patellar stabilization with isolated MPFL reconstruction.

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