Background: Lisfranc fractures are rare injuries, with reported incidence of 0.2% of all fractures and 1/55,000 per year incidence in the population. These are reported to occur 2-4 times more commonly in men, and the peak incidence is in the third decade of life. Objective: This study was aimed to assess the functional outcome of using open reduction and internal fixation in management of ligamentous Lisfranc injuries. Patients and Methods: This prospective operative study was conducted on 18 patients with Displaced Lisfranc injury admitted to the Orthopedic Surgery Department, Faculty of Medicine, Zagazig University, during the period from February 2021 to August 2021. The diagnosis was made by medical history taking, clinical examination and radiological assessment. Results: The mean operation time was 140.0±27.43 minutes with minimum 90 and maximum 200 minutes and mean hospital stay was 4.38±1.33 with minimum 3 and maximum 8 days. The mean healing time 8.38±2.45 with minimum 6 and maximum 16 weeks. The most prevalent complication was infection (22.2%), Transient numbness (5.6%), Delay healing (5.6%), Loss reduction (5.6%) and overall complicated cases were 5 cases 27.8%. Conclusion:It could be concluded that anatomical reduction of Lisfranc injury can be achieved by open reduction and internal fixation with the Kirschner wires (K-wires) and Cannulated Screws.

Background: Open or closed reduction with Kirschner wires, screws, and flexible nails has been documented for the treatment of displaced proximal humeral fractures, however percutaneous K-wire fixation is the most widely utilized procedure.Objective: This study aimed to evaluate short-term clinical and radiographic results of percutaneous pinning of surgical neck-humerus fractures in children and adolescents using k-wire. Patients and Methods: Our study was done on 18 patients with fractures of the surgical neck of the humerus at Zagazig University Hospital treated by percutaneous pinning using k-wire. The humerus fractures were followed up clinically and radiologically for 6 months. Neer and Horwitz classification was used to classify fractures. Constant-Murley shoulder scoring system were used to evaluate results. Results: According to Constant-Murley scoring system the result obtained were excellent in 14 patient (77.78%) and good only in 4 cases (22.22%). Concerning the complications of the current study, 11 cases had no complication (61.11%), 3 cases had stiffness (16.67%) and 4 cases had superficial infection (22.22%). 4 cases of superficial infection were treated with antibiotics and daily dressing. K-wires were not required to be removed early. All of them achieved excellent results. 3 cases of stiffness were completed by physiotherapy, 2 of which yielded good results and 1 of which yielded excellent results. Conclusion:Fractures of the surgical neck in children and adolescents can be successfully treated with percutaneous kwires technique, which provides stability after reduction of fractures. Early and adequate physiotherapy program gives better results regarding the range of motion.

Background: Conservative approaches as Ponseti Technique in managing Talipes Equinovarus could lead to various serious consequences, surgical treatment could if necessary. Objective: The aim of the work was to assess the functional and radiological outcome of surgically treated clubfeet after failure of Ponseti technique in children. Patients and Methods: Twelve clubfeet in twelve patients were undergoing posterior medial release in this prospective study at the Orthopedic Department, Zagazig University Hospitals during the period from November 2020 to the end of August 2021 and followed up in out-patients clinics, follow-up period from three to six months. The selected cases were thoroughly examined clinically and radiologically pre-and postoperative. Results: All postoperative cases were plantigrade; with no poor results were noticed. most cases (81.25%) were with excellent to good results while the remaining (18.75%) were fair with plantigrade foot. Lateral talocalcaneal angle was 12.75±4.65° before surgery; and changed after posterior medial release 40.83±4.37°. The increase was significant (P<0.001). Anteroposterior talo-first metatarsal angle was also with significant change from pre to after posterior medial release (P<0.001). As regard complications, there were intraoperative bleeding (two patients) as well as postoperative infections (one patient) and plaster sores and dermatitis (four patients). Conclusion:It could be concluded that in failed Ponseti technique there is adhesion under the skin of the distal tibia and there is adhesion and fibrosis around the incision of the tendon Achilles certain point should be fulfilled to obtain complete reduction and anatomical restoration of the foot after failed Ponseti.