No abstract

Operative intervention is a good management of these fractures and results in an anatomic reduction, a solid bone union and prevents valgus instability. Even with postoperative immobilization of the elbow (mean of 4 weeks), stiffness is rare. Damage to the medial stabilizing structure of the elbow rather than the extent of medial epicondyle displacement has a far greater influence on joint stability and outcome.

Bone reconstruction after surgical resection of bone malignancies in children remains a difficult challenge. Induced-membrane reconstruction as described by Masquelet et al. was originally reported in traumatic or septic bone defects and is now adapted to this field. We report here three cases of massive femoral graft resorption requiring surgical revision in two boys aged 3 and 6 years and a 9-year-old girl. Hypotheses include the long delay between the two stages, nature of the bone graft, high varus loads specific to this location, and lack of stability of the fixation. This technique has recently provided promising preliminary results when applied to the field of bone tumours. However, reconstruction of the femur seems to be specifically associated with a risk of graft resorption. Identification of the origin of this major complication is needed to amend the technique or its indications.

Autologous osteochondral mosaicplasty to manage OCDP in adolescents appears to be a reliable technique on the short term to restore patellar joint surface and obtain satisfactory functional results.

Thirty-six cases of femoral lengthening using the Albizzia nail were performed. The indication for lengthening was a congenital malformation, sequellae of trauma, of infection, of radiation therapy, short stature, and vascular malformation. The mean age of the patients was 16 years, the average lengthening achieved was 4.7 cm, and the follow-up period averaged 5.8 years. We found that bone consolidation was achieved faster than with external fixation. The patient's comfort during lengthening as well as the speed of functional restoration also improved. In three cases, the program failed, in six the lengthening was achieved with a second procedure, and eight patients required one ratcheting or more under general anesthesia. In our experience, the Albizzia nail is a simple and effective solution for uncomplicated femoral lengthening.