We assessed whether the range of passive hip motion is reliable for predicting abnormal femoral anteversion. We measured the passive medial and lateral rotation in extension in both hips of 1,140 children between 8 and 9 years of age. The children were divided into 3 groups: group 1: difference between lateral and medial rotation less than 10 degrees; group 2: medial rotation more than 10 degrees greater than the lateral; group 3: lateral rotation more than 10 degrees greater than the medial. Group 1 comprised 90% of the children, whereas 8% belonged to group 2 and 2% to group 3. The angle of femoral neck anteversion was measured in 57 children from the first group, in 67 from the second and in 24 children from the third group, using biplane radiography. The mean anteversion angles in the 3 groups were 24 degrees, 36 degrees and 14 degrees, respectively. To predict an abnormally high anteversion angle (above mean +2SD), the difference between medial and lateral rotation must be 45 degrees or more, whereas an abnormally low anteversion angle (lower than mean -2SD) could be predicted when the lateral rotation was at least 50 degrees higher than the medial rotation.

Aneurysmal bone cyst is a benign, locally destructive lesion of bone. Based on progressive cortical thinning pathological fractures are common, and are often the presenting feature. Despite the long experience of orthopaedists, radiologists and pathologists with aneurysmal bone cyst there is limited knowledge regarding the cause of the lesion and optimal treatment. Common methods of treatment vary considerably in the literature, particularly in children. A large variety of bone substitutes have been used to fill the cystic lesions. To date there has been no graft material which can be regarded as completely satisfactory. Our experience with freshly isolated autologous bone marrow derived mononuclear cells combined with β-tricalcium phosphate and absorbable atelocollagen for bone formation is presented. The concept of this treatment is based on stimulation of natural events continuously present in living bone appear to be a reasonable and beneficial alternative to promote healing of bone cysts and offering both osteoinduction and osteoconductive features.

Thirty-nine patients with foot injuries were admitted to the Clinic for Orthopedic Surgery in Lovran during the war against Croatia. All of them were soldiers wounded by antipersonnel mines. All of the patients were treated using the same protocol. Primary wound care included debridement, necrectomy, and three-dimensional external fixation with or without Kirschner wires. External fixation facilitated postoperative wound care, prevented vicious contracture position, and made fracture healing possible with early weight bearing.

No abstract