Introduction Pigmented villonodular synovitis (PVNS) is a benign idiopathic proliferative disorder that results in villous or nodular formation in the joints, tendons sheaths, and bursae. As PVNS is a rare pathology in children, diagnosis is often delayed. In this study, we analyze the therapeutic methods used and results obtained in the treatment of this pathology. Materials and methods All patients with PVNS of the knee seen between January 1988 and June 2006 were evaluated. We assessed the form of presentation, time to diagnosis, previous diagnosis, type of treatment, relapse, and the need for subsequent treatment. Results Nine patients with age range 2-15 years and a mean follow-up of 8.5 years were evaluated. Four patients had the diffuse form and four had the localized or nodular form; all of them were intra-articular. In only three cases were preoperative radiographic findings observed. The mean delay in diagnosis was 18 months. Open resection was performed in five patients and arthroscopic resection in four. Joint function was satisfactory in 78% of the patients at the last follow-up and there were no postoperative recurrences. Conclusions Magnetic resonance imaging (MRI) is a useful diagnostic tool and the way to detect relapse, and allows accurate determination of the tumor extent. Surgery is the treatment of choice. Worse results are directly related to delay in diagnosis.

Although both methods are effective in stopping the growth, the 8-plate has better grasp to the bone or epiphyseal cartilage avoiding extrusion in small children. The correction is faster using a staple and that is the reason why we prefer its usage in patients with little remnant growth.

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Purpose To evaluate the efficacy of decompression of unicameral bone cysts (UBCs) of the long bones with intramedullary nailing and to compare responses to treatment according to location. Materials and methods We evaluated 48 consecutive patients treated between January 1988 and June 2000. Mean age was 10.3 years. Mean follow-up was 9.8 years. Evaluation was performed according to the radiographic criteria of Capanna. Results UBCs were located in the proximal humerus (n = 24), humeral shaft (n = 2), proximal femur (n = 19), distal tibia (n = 2) and fibula (n = 1). A total of 62.5% presented a pathological fracture. Successful results were observed in 89.5% (26 total healing, 17 healing with residual radiolucent areas), and there were four recurrences and, in one case, no response to treatment. There was more healing in the humerus than in the femur (92.3% versus 84.2%), and more tendency to restitution ad integrum, although the difference was not statistically significant (P = 0.1499). Conclusions Intramedullary nailing is a minimally invasive method, which permits early stability and decompresses the cyst allowing healing. Significant differences were not observed among results from different locations.

Introduction Distal radius fractures associated with ligament or distal epiphyseal injuries of the ulna occur less frequently in skeletally immature patients. The underestimation of the mechanisms of injury leads to conservative management of this type of fracture, resulting in unsatisfactory reductions and loss of range of motion. Materials and methods Between January 2000 and March 2008, ten cases that were referred to our institution from other centers were studied. Treatment was joint reconstruction. The mean age was 11.9 years. Mechanisms of the fracture, as well as the delay of diagnosis, definitive reduction, and the number of surgeries previously performed, were analyzed. Results The mean follow-up until the skeletal maturity of the patients was 3.4 years. The mean number of surgeries before the definitive treatment was given was 2.1, varying from attempts of closed reductions under anesthesia to percutaneous pinning in most of the cases. Eighty-seven percent of the patients improved their range of motion after the definitive surgery in the last follow-up, and there has been no evidence of growth disorders. Conclusions The presented fracture pattern is generally undervalued when evaluating management in children; the reduction of this type of injury should be surgical in order to achieve an adequate alignment. Parents should be informed about the treatment, its evolution, and possible subsequent surgeries to reestablish the joint axes and the adequate length of the wrist bones.