Our results suggest that this technique is safe, effective and gives satisfactory outcome in the operative correction of Blount's disease.

Objectives:The level of fibular osteotomy has a role in the incidence of peroneal nerve palsy (PNP). This study aims to compare the prevalence of PNP among patients who had fibular osteotomy at two different levels.Materials and Methods:Sixty-nine limbs in fifty-two patients had valgus osteotomy of the proximal tibia and fibular osteotomy at two different levels — the proximal half (Group 1) and distal half (Group 2). The results of these were compared.Results:The incidence of peroneal nerve palsy was 23.6 and 3.2% in Groups 1 and 2, respectively (P < 0.025).Conclusion:This study supports the choice of the distal half for fibular osteotomy.

From October 2005 to August 2007, we operated on six patients who had femoral non-unions and performed interlocked intramedullary nailing without X-ray guidance or a targeting device. There were three fractures of the distal femur, two fractures of the mid-shaft and one of the proximal femur. Fatigue failure of a non-interlocked Kuntscher nail and one nail migration were the presenting features in two patients. The presence of sclerosis of the bone ends in four cases and a need for cancellous bone grafts at the site of non-union in all patients made wide dissection and open reduction unavoidable. There was a limb length discrepancy in all patients before surgical intervention. Partial weight bearing was commenced at 6 weeks post-operation. There was no case of wound infection. There was no misplaced screw. Minimum range of knee flexion was 105° at 2 months post-operation. These early results call for a closer look at this cheap, safe and effective means of handling femoral non-union in third world societies where there is paucity of instrumentation and implants for interlocked nailing.

Background and Objective:The Stracathro approach to the hip is a modification of the lateral approach, which was popularized by Hays and McLauchlan. It has a high safety profile and a low rate of hip dislocation. However, the need for osteotomy increases blood loss, risk of intraoperative fracture, and postoperative heterotopic calcification. In sub-Saharan Africa, where traditional healers dabble in the treatment of all musculoskeletal conditions, extensive soft tissue contractures and disuse osteoporosis arise and further complicate the lateral approach. The objective of this article is to highlight modifications made to the stracathro approach and present the short-term results in a group of 26 patients, who had hemiarthroplasty using this technique.Materials and Methods:All patients presenting with subcapital or transcervical fracture of the femoral neck after the age of 50 years were offered hemiarthroplasty using the modified Stracathro approach, with follow-ups for a period ranging from 28 – 84 months.Results:A majority (23 out of 26 – 88.5%) of patients presented late for the treatment, due to the patronage of traditional bonesetters. In spite of the soft tissue contractures and osteoporosis associated with late presentation, there was no case of intraoperative fractures. The patients had good hip abduction postoperatively. In addition, there was no intraoperative nerve or vascular injury.Conclusion:The short-term results in this group of patients showed that the modified Stracathro approach was safe and useful in hemiarthroplasty, for patients with soft tissue contracture and osteoporosis.

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