The objective of this study is to present treatment of fibular hemimelia along with the complications, results, and an algorithm for treatment indications on the basis of authors' experience. A group of 31 patients was studied. In patients fulfilling the criteria for amputation, Syme's amputation should be performed. Elongation should be performed in case of type IA or IB fibular hemimelia, with a functional foot with more than three rays, leg shortening less than 5 cm at birth, and less than 10 cm at 9 years of life. The combination of epiphysiodesis with elongation produces the best outcome and is best accepted by the patients.

Background: Although Fassier-Duval (FD) rods have been used for almost 2 decades, knowledge of factors predisposing to their failure is limited. Thus, the purpose of this study was to: (1) present the most common complications of FD rodding, (2) present tips on how to avoid or overcome them, and (3) identify factors predisposing to treatment failure. Methods: Fifty-eight rod segments in 19 patients with osteogenesis imperfecta (mainly type III) underwent analysis with a median follow-up (FU) time of 4.4 years. We assessed the total number of complications clinically and radiographically. Next, the possible predisposing factors leading to failure were assessed using the Mann-Whitney U test. In addition, we evaluated the cutoff age for the increased rate of complications using the Youden index. A P<0.05 was considered significant. Results: The total number of complications reached 44.8%. The most common complications included: migration of the male or female implant (45.7% and 25.7% out of the total number of complications, respectively), bone fracture with bending of the rod (8.6%), and rotational deformities (8.6%). Significant differences in patients’ ages at the time of surgery were found between the group with and without complications (P=0.04), while sex, segment treated, preceding surgeries, length of FU, FD rod diameter, and length of bisphosphonate treatment were not significant. The Youden index showed that the risk of complications rose significantly in patients treated when younger than 5.5 years of age (P<0.05). Conclusions: This series displays the effectiveness and utility of FD rods at a median FU of over 4 years. Complication rates were comparable with the existing literature, with a notable increase in the number of side effects observed in younger patients (below the age of 5). Level of Evidence: Level IV—therapeutic study.

1. FD rodding allows for decreasing the number of operations because the nails need not be replaced as the child grows older. 2. FD rod implantation is limited by the size of the medullary cavity of the bone, and thus the age of the patient.

1. Familiarity with CRMO in orthopaedic clinical practice is indispensable in differential diagnosis with other bone diseases, including those suggestive of malignancy. 2. Correctly diagnosed CRMO is managed conservatively as a treatment of choice.

STRESZCZENIEWstęp. Zła ma nia głów ki ko ści ra mien nej wy stę pu ją nie zwy kle rzad ko. W pol skim pi śmien nic twie brak donie sień oma wia ją cych le cze nie tych zła mań. Pra ca ma na ce lu przed sta wie nie wła snych wy ni ków le cze nia i porów na nie ich z do nie sie nia mi in nych au to rów.Ma te riał i me to dy. Przed sta wio no gru pę 9 cho rych w wie ku 7-17 lat (śr. 14 lat). U jed ne go cho re go (11%) wy stą pi ło zła ma nie nie prze miesz czo ne, zaś u 8 (89%) cho rych zła ma nie by ło prze miesz czo ne po wy żej 2 mm. Od po wied nio do ro dza ju zła ma nia za sto so wa no le cze nie za cho waw cze u jed ne go cho re go, zaś ope ra cyj ne u po zo sta łych. U dzie ci le czo nych ope ra cyj nie, głów kę ko ści ra mien nej ze spo lo no 1x śru bą biow chła nial ną, zaś 7x dru ta mi Kir sch ne ra. Do oce ny obiek tyw nej funk cji łok cia uży to ska li: Mayo El bow Sco re (MES), na tomiast su biek tyw nej oce ny funk cji łok cia pa cjent do ko ny wał na pod sta wie Oxford El bow Sco re (OES).Wnio ski. 1. Nie prze miesz czo ne zła ma nia głów ki ko ści ra mien nej po win ny być le czo ne za cho waw czo. 2. Zła ma nia z prze miesz cze niem po wy żej 2 mi li me trów na le ży na sta wić ope ra cyj nie z prze zskór ną sta bi li za cją dru ta mi Kir sch ne ra.Słowa kluczowe: złamanie główki kości ramiennej; złamania kończyny górnej; złamania kości ramiennej u dzieci; złamania stawowe łokcia SUMMARY Background. Capitellar fractures are extremely rare. The Polish literature does not provide any reports on the treatment of these fractures. The aim of this paper is to present our treatment results and to compare them with reports from other authors.Material and methods. We investigated a group of 9 patients aged 7-17 years (mean age 14 years). One patient (11%) had sustained a non-displaced fracture, while 8 (89%) had sustained fractures with more than 2 mm displacement. According to the type of fracture, one patient was treated conservatively and the others underwent surgical treatment. In the children who were operated on, the humeral capitulum was fixed with a bioabsorbable pin in one patient and with K-wires in seven patients. Objective elbow function was evaluated using the Mayo Elbow Score (MES). Subjective elbow function was evaluated by patients on the basis of the Oxford Elbow Score (OES).Conclusions. 1. Non-displaced capitellar fractures should be treated conservatively. 2. Fractures with more than 2 mm displacement should be reduced surgically with percutaneous fixation with K-wires.