Background: Capitate shortening is the best decompression procedure in the management of Kienböck’s disease in patients with ulnar neutral or positive variance, although carpal collapse develops inevitably. The current study was to report our experience in partial capitate shortening osteotomy as an alternative procedure. Methods: This was a prospective study of 20 patients with Lichtman stage II and IIIa Kienböck’s disease managed by partial capitate shortening osteotomy. Results: At final follow-up (average 36.5 mo), visual analog pain scores improved significantly postoperatively to 3.3. Flexion and extension improved from 62% (±17%) and 52% (±21%) preoperatively to 63% (±13%) and 68% (±13) postoperatively, respectively. The power grip improved significantly from 49% (±16%) to 63% (±12%) postoperatively. The average quick Disability of the Arm Shoulder and Hand Score improved from 60.8(±13.8) to 38.3(±13.9) postoperatively. Conclusions: Partial capitate shortening is a simple and effective procedure for the management of ulnar neutral or ulnar positive Kienböck’s disease before the onset of radiocarpal arthrosis without violation of scaphocapitate joint thus avoiding carpal collapse that follows complete capitate shortening. Type of Study/Level of Evidence: Therapeutic IV.

Angular deformities of the lower limbs are common during childhood. The concept of guided growth using a tension band plate is a breakthrough in the surgical correction of angular deformities. This approach has yielded satisfactory results and has low complication rates. We reviewed 210 papers with overall 433 patients and 809 deformities. Inclusion criteria included papers published from 2010 to 2017 in English literature. A Systematic review was done on 16 papers with seven outcomes: Change in mechanical axis deviation, tibiofemoral angle, rate of excellent outcomes, implant breakage, implant migration, inadequate reduction and rebound phenomenon. Thirty-two studies were included. Fifteen of them studied treatment of angular deformities by guided growth, three discussed the complications of using guided growth and five studies discussed biomechanics of using guided growth. Sixteen studies were included in our systematic review. Guided growth is effective in treating coronal deformities around the knee in skeletally immature children whether the cause was idiopathic or pathological. There is no limitation except if physeal bar is developed or the patient was near maturity. Few complications are associated with guided growth techniques including rebound phenomenon, inadequate reduction, implant breakage and implant migration.

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The treatment of intra-articular fractures of the calcaneus remains controversial. Different approaches and methods of fixation are used aiming at anatomical reduction and achieving good functional outcome. Patient and methods: 10 patients were included in this study with age range from 20 years to 36 years with mean age 28 years. According to Essex-Lopresti classification, all fractures were joint depression fractures. There were 5 fractures classified as Sanders II , 3 fractures were classified as Sanders III and 2 fractures were classified as Sanders IV. All patients were managed operatively using limited lateral approach and trans-articular k-wires fixation.Results:The mean follow-up duration was 6.20 months. The mean Maryland foot score was 85.50. Complications included pin track infection in 2 cases which were treated conservatively, complex regional pain syndrome in 2 cases, both responded well to physiotherapy, restriction of subtalar joint movement in 3 cases which were treated by physiotherapy .The Sanders classification of fractures was found to be correlated significantly to Maryland foot score.Conclusion : open reduction of displaced intra-articular calcaneal fractures through limited lateral approach and percutneous trans-articular k-wires fixation technique was found to be effective method for treatment of Sanders type II and III , joint depression fractures.