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Back ground : patients with pilon fractures and distal comminuted fractures, These fractures give the surgeon a great challenge In methods of fixation starting from External fixator up to platting and Illizarov But our method of fixation which Is Triangular External fixator acheive a great success.

The management of children with a pink pulseless hand in severely displaced supracondylar humeral fractures remains controversial regarding immediate exploration of the brachial artery and revascularization during fracture fixation or just closed reduction of the fracture and percutaneous pinning and follow up of limb perfusion.Between 2012 and 2016 we followed 52 children with displaced supracondylar fracture humerus. All patients had absent radial pulse with an otherwise well perfused hand. The radial pulse was returned in all patients, without surgical exploration after closed reduction of the fracture and percutaneous pinning .It takes variable periods from 1week to 2 months . Radial pulse recovery may be due to recanalization of brachial artery or by collaterals. So closed reduction of the fracture, percutaneous pinning and observation is a good option of treatment pediatric supracondylar humeral fractures with a pink pulseless hand without need to do early revascularization procedures.PDF created with pdfFactory Pro trial version www.pdffactory.com

Recently, much attention has been focused on measuring the severity and prevalence of malocclusion and orthodontic treatment need worldwide. The recorded frequency of dental malocclusion among different countries has been

Introduction The optimal treatment of humeral shaft fractures continues to be debated. In the current investigation, we sought to determine the clinical and radiographic outcomes following the plate fixation of humeral shaft fractures utilizing the modified posterior approach. Materials and methods A retrospective review identified a consecutive series of 30 humeral shaft fractures (OTA20-A, 10-B, or 0-C) treated with plate fixation via a posterior (14 patients), ormodified posterior approach (16 patients) between 2016 and 2017 by a single surgeon. Demographics, operative reports, clinical follow-up, and preoperative radiographs were reviewed. Postoperative radiographs were assessed for angular deformity and time to union. Range of motion and strength testing were also reviewed. Results A total of 30 humeral shaft fractures were reviewed with a mean clinical follow-up of 4 months. The mean time to union was13.1 weeks and there3 patients developed radial nerve palsies in posterior approach group and one case in modified posterior approach postoperatively. Conclusionboth approaches could be used in the management of humeral diaphyseal middle or distal third fractures, And the modified posterior approach confirmed by our results minimizes the complication rate, allow early return of full range of elbow motion and full triceps muscle power and facilitates early return to normal activities of the patient with excellent functional out comes .