A retrospective review of 60 diaphyseal tibia fractures (31 closed and 29 open fractures) treated with flexible intramedullary fixation was conducted. All charts and radiographs were reviewed. Children ranged in age from 5.1 to 17 years. Fifty patients with 51 fractures were followed up until union and comprised the study group. The mean follow-up period for these 50 patients was 79 weeks. Forty-five fractures achieved bony union within 18 weeks (mean, 8 weeks). Five patients (11%) had delayed healing (3 had delayed unions that ultimately healed with casting or observation, and 2 had nonunions that required secondary procedures to achieve union [1 patient underwent a fibular osteotomy, and 1 underwent exchange nailing with a reamed tibial nail]). These 5 fractures ultimately healed, with a mean time to union of 41 weeks. Patients with delayed healing tended to be older (mean age, 14.1 years) versus the study population as a whole (mean age, 11.7 years). In addition to delayed union, other complications were observed in the study population. One patient healed with malunion (13-degree valgus), requiring corrective osteotomy. One patient with a grade II open fracture was diagnosed with osteomyelitis at the fracture site after attaining bony union. Two patients developed nail migration through the skin, requiring modification or nail removal. The fixation of pediatric diaphyseal tibia fractures with titanium elastic nails is effective but has a substantial rate of delayed healing, particularly in older patients.

Simultaneous arthroscopic treatment of an OLT and open lateral ankle stabilization is a safe and effective procedure. The presence of an osteochondral lesion had a negative effect on the overall result when compared to that of patients who underwent lateral ankle stabilization as an isolated procedure.

Advances in shoulder arthroscopy have led to a greater understanding of the importance of lesions of the superior labrum and biceps tendon complex. Diagnosis of superior labrum anterior to posterior tears requires a high index of suspicion and is made by careful attention to the history, physical examination, and magnetic resonance arthrography. The diagnosis is confirmed with arthroscopy. The form of treatment is dependent on the type of tear and the stability of the superior labrum and biceps anchor. Appropriate treatment of the tear and any associated pathologies should lead to reliable improvements in the patient's symptoms. The purpose of this review article is to describe the anatomy, pathophysiology, classification, indications, and surgical technique of arthroscopic repair of superior labral tears. The surgical technique we present involves using 1 anchor with 2 sutures to anchor the superior labrum anterior to posterior tear to the superior glenoid tubercle.

Standardized muscle strength determination and completion of an MFA questionnaire provided a thorough evaluation of patients who had undergone open reduction and internal fixation of a displaced acetabular fracture. In these patients, hip muscle strength after operative treatment of a displaced acetabular fracture directly influences patient outcome. Therefore, in order to maximize the outcome of these patients, particular attention must be paid to postoperative muscle strengthening protocols and accurate and validated methods to assess strength and outcomes.