The case of a 13-year-old girl with striking carpal and tarsal osteolysis (sporadic occurrence) is reported. MRI confirmed the total absence of carpal bones and medial tarsal bones. Dense fibrocollagenous tissue replaced the spaces left by the resorbed bones. Arteriography showed occlusion of the radial artery at the level of the physis of the distal radius with increased tortuosity of the ulnar artery. There was no major vascular occlusion in the foot except for some indistinct and blurred tarsal branches of the anterior tibial artery.

A modified Wagner technique using an Orthofix was employed for femoral lengthening in 62 skeletally mature patients with residual poliomyelitis. The first stage was similar to that of the original Wagner technique. However, distraction was started after 5 to 7 days at a rate of 1.5 mm per day. At the second stage, a neutralization plate was applied and a corticocancellous iliac strut graft inserted in the distracted site, preferably under compression. Cast immobilisation was not used and a long leg brace with a thigh corset allowed early knee movement and weightbearing. The average age at operation was 26 years and 6 months. The period of follow-up averaged 3 years and 2 months, and the average amount of lengthening was 4.2 cm. The overall rate of complication was 34%. R~sum~. Une variante de la mdthode de Wagner d'allongement du fdmur utilisant l'Orthofix, a dt6 appliqu6e it 62 adultes d'gtge moyen de 26 ans et demi, prdsentant des sdquelles de poliomydlite. La premibre 6tape est presque identique it la mdthode de Wagner originale, toutefois l'allongement a 6t~ rdalisd it partir du 5 -7 dme jour, au rythme de 1.5 mm par jour. Pour la deuxibme dtape, une plaque vissde a 6td mise en place et un greffon cortico-spongieux iliaque a dtd insdrd entre les deux fragments, de prdfirence en compression. Cette mdthode ne ndcessite pas d'immobilisation plg~trde et permet la mobilisation pr6coce du genou ainsi que la reprise pr6-coce de l'appui sous couvert d' une orthbse. L' allongement moyen obtenu a dtd de 4.2 cms; il y a eu 34% de complications secondaires, avec un recul de 3 ans et 2 mois en moyenne.