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Bifocal compression-distraction osteogenesis is a safe, reliable, and largely successful method for the acute treatment of open tibia fractures with bone and soft-tissue loss. Further nonoperative or operative treatment can correct most complications.

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Sagittal spinal alignment is found to be changing as a child grows. There is a statistically significant difference among different age groups, especially at cervicothoracic, thoracolumbar, and lumbosacral junctions. The position of the sacrum (inclination and translation), and spatial orientation, as well as the global magnitude of thoracic kyphosis, and lumbar lordosis changes with growth. These findings should be taken into consideration for the young patients who require spinal instrumentation. The question "whether sagittal alignment should be restored according to the normative data for the child's age or to the normative data for the adulthood" remains to be answered.

Angular compression to the side of the defect is a safe and reliable method of treatment for asymmetrical bone or soft tissue defects of tibia. It eliminates the need for complex soft tissue reconstruction procedures. Unnecessary debridement of bone is prevented by angular adaptation of edges. Definitive treatment of complex injuries is possible with a circular external fixator.