Background . Background Scaphoid fractures constitute around 2-3% of all fractures and about 10% of all the fractures in the hand. The indication of closed treatment of fractures with scaphoid is generally confined to stable fractures without displacements. Kirschner wires, screws and staples incorporate operational approaches. Both flying and dorsal methods have been documented as percutaneous methods (pins and cannulated screws). Purpose The objective of the research is to undertake a comprehensive analysis of previous available research on various ways of managing acute scaphoid fractures. Patients and procedures The search for literature was done using PubMed, SCOPUS, Web of Science, and the Cochrane Library. Search and filtering literature produced 7 full text publications (254 patients), randomised controlled trials were included. Results Surgical fixation on scaphoid fractures results in better rates of union and quick union times of 5 to 9 weeks. As for casting, the union usually takes around 7 to 16 weeks and the union rate is between 85 and 90%. ROM 90 percent -97 percent following conservative scaphoid fracture therapy, whereas surgical therapy was 88 percent -97 percent. Grip strength was 88%-98% improvement with conservative therapy and 84%-94% following surgical therapy. The return to work was surgery for 6-8 weeks before, but for those who were receiving conservative therapy it was 4-15,5 weeks. Conclusion Our analysis showed no statistically significant difference in overall complications between surgical and non-operative therapy. However, independent study demonstrated that surgical therapy had the benefit of delayed union, backed by time-to-fracture union analyses.

The purpose of this study was to evaluate the clinical, functional and radiological outcome of lateral calcaneal lengthening osteotomy and medial soft tissue plication for correction of symptomatic flatfoot deformity in children. A prospective multicenter study on 22 feet of 20 patients who underwent lateral calcaneal lengthening for symptomatic flatfoot in children by Mosca technique in the period between December 2017 and February 2019. Inclusion criteria were symptomatic flexible flatfoot in children with failed non operative treatment. During the study period, 22 feet of 20 patients with symptomatic flatfoot underwent lateral calcaneal lengthening osteotomy. All patients met the inclusion criteria and were available for clinical and radiological follow-up. The percentage female were (55%)-male were (45%), The mean age at time of surgery was 10.33 years old (7 -17 years old) and their mean follow up period was 15months.The mean functional American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot score had improved from 68.9 (58-78) preoperatively to 96.09 (86-100) postoperatively at last follow up (P value < 0.001) using paired t-test as a significance test for evaluation of pre and post-operative AOFAS score.The results of this study support the combination of lateral column lengthening and soft tissue reconstruction for treatment of PesPlano-valgus foot deformity, The adopted technique revealed satisfactory result both in children and adolescents.

Medial opening wedge high tibial osteotomy is one of the standard procedures used frequently to manage varus deformity of the knee through shifting the load laterally in the knee. To assess the safety and efficacy of opening wedge high tibial osteotomy using the puddu plate in patients with genu varum deformityThis study was conducted on 22 knees in 20 consecutive patients who had performed medial opening-wedge high tibial osteotomy using Puddu plate between October 2017 and May 2019 for varus malalignment. This study was conducted in Benha university hospitals. The total knee society score was compared between preoperative and postoperative to assess the patients' outcome. Also individual elements of the score including alignment, instability and range of motion were assessd postoperatively. Varus angle and mechanical axis deviation were measured preoperative and postoperative.In this study, there was a significant improvement of knee society score post operatively. (P value <.00001). There was significant improvement of mechanical axis deviation with pre-operative mean 17.82 mm to post-operative -2.23 mm (valgus). (P value < .00001). Patients started partial weight bearing at 8 weeks, then, full weight bearing started at 12 weeks, most patients returned to work after 15 weeks.The findings of our study showed many benefits of medial opening wedge high tibial osteotomy with puddu plate procedure including easier procedure, no need for bone graft. This procedure had satisfactory outcomes regarding union rates pre and post-operative scores, patient satisfaction and low rate of complications.

Background: Tibial plateau fracture is challenging for orthopedic surgeons because of the severity of trauma and associated soft tissue injuries. The treatment goals are to anatomically reconstruct the proximal tibial articular surface, restore limb axial alignment, and fix metadiaphyseal comminution to allow early knee mobilization and weight bearing. Aim: To evaluate the functional, clinical and radiological outcomes of treatment of high energy tibial plateau fractures by circular external fixator ± percutaneous screw fixation.