No abstract

Based on this review, no recommendations can be made as to what defines an acceptable reduction or which fractures would benefit from surgical intervention. Angular deformity seems to correct to an acceptable alignment in patients less than 10 years of age, but these younger patients seem to be at higher risk for symptomatic shortening if a growth arrest occurs. Redisplacement after reduction is fairly common, and other more severe complications such as pain, loss of motion, and nerve injury can occur.

Gunshot injuries to the hip can be devastating, leading to posttraumatic arthritis and presenting a surgical challenge at the time of total hip arthroplasty (THA) due to the presence of metallic fragments and damaged soft tissues. However, there are few reports of gunshot-related posttraumatic arthritis. The purpose of this study was to describe the features and report the early outcomes of THA in 4 patients who developed posttraumatic arthritis from gunshot injuries to their hips 2, 10, 18, and 26 years after their initial injury, respectively. All 4 patients underwent successful THA without complications. None of the patients had undergone a revision procedure at a mean 26-month (range, 12-48 months) follow-up. The authors believe that primary THA is a safe and effective procedure to reduce pain and improve function for gunshot-related posttraumatic arthritis in patients in whom nonoperative management failed.

Pediatric proximal tibial epiphysis fractures are uncommon and have subsequently received little attention in terms of treatment and outcomes. We studied the clinical and functional outcomes of 13 patients with Salter-Harris III and IV fractures of the proximal tibial epiphysis after operative fixation. Associated meniscus, ligamentous, or neurovascular injury was present in 100% of this cohort. Provisional external fixation and locked plating spanning the open physis were used in the majority of cases. The mean clinical follow-up was 15.69 months, where all fractures progressed to union. Good functional outcomes with a low complication rate are possible after operative fixation of these infrequent injuries.