Conservative treatment of the displaced supracondylar fractures of the humerus in children

145 displaced supracondylar fractures of the humerus in children were treated by manipulation and alternative immobilization in flexion and extension of the elbow joint by a posterior plaster slab. After a period of follow up of 4-36 months, 62% of the cases had satisfactory results which were more prevalent among cases fixed in extension. Among the complications met with during treatment were, limitation of elbow flexion in 24.8% of cases and extension in 5.3%. This limited movement was found to improve with time. Changes in the carrying angle in 13.8% was also found, and was more prevalent in cases fixed in flexion rather than in extension. Hyperextension deformity of the elbow on the other hand was present in 3.4% of cases and mainly in cases fixed in extension

Closed management of fractures of the proximal and middle phalanges by percutaneous Kirscher wire fixation

Fourty two fractures of the proximal and middle phalanges of the fingers were treated by percutaneous Kirschner wire fixation under local anaesthesia. In transverse, short oblique and fracture separation of the epiphysis an intramedullary pin was used. In long oblique and comminuted fractures two or more oblique crossing wires perpendicular to the fracture lines were used. After a period of follow up between 4 to 12 months with an average of 7.2 months the results obtained were 71.4% good, 14.1% fair and 14.1% poor. Among the complications met with were flexion deformities of the interphalangeal joints in 19%, angulation deformities in the fracture site in 14.3%. Boutonniere deformity on the other hand occured in two cases

Surgical treatment of the displaced supracondylar fracture of the humerus in children using the medial approach

38 displaced supracondylar fractures of the humerus were treated by open reduction and internal fixation with two Kirschner wires using the medial approach. After an average follow up period of 6 months 90% of the cases had satisfactory results. The result was found to be significantly affected by the preoperative trials of manipulations to achieve closed reduction, the time delay before operation and the accuracy of reduction achieved during surgery. Among the complications met with were limitation of elbow movement in 26% and cubitus varus in 23.3% of cases

Operative treatment of displaced supracondylar fractures of the humerus in children by the posterior approach

Thirty displaced supracondylar fractures of the humerus in children were openly reduced and fixed by two Kirschner wires through the posterior approach. Four fractures were not manipulated before surgery, while 26 were manipulated from one to four times. The time delay before operation ranged from 2 to 20 days. Cases followed for 6 months and up to one year had satisfactory results in 63.6% of the cases. Cases followed for less than 6 months had 27.3% satisfactory results. Limitation of elbow movement [59.6%], changes in the carrying angle [40%] and heterotropic ossifications [3.33%] were among the complications met with in this series

Conservative treatment of fractures of the middle third of the shaft of the humerus

Fourty five cases of recent closed fracture of the middle third of the humerus were followed after treatment either by a U-shaped slab and body bandage or a shoulder spica. 23 fractures were treated by the first method and 22 by the second. Excellent and good results were obtained in 91.3% of the U-shaped slab method and 54.6% of the shoulder spica method. Distraction, angulation deformity and stiffness of the joints were encountered during treatment

Surgical improvement of the calcanean deformity of the foot after poliomyelitis

Thirty calcanean feet were surgically treated to improve their function and appearance. The average age at operation was 9.6 years. Tendon transfer using different combinations of both peronoi, tibialis anterior and tibialis posterior was performed. Bone stabilizing operation proceeded all tendon transfer. After an average follow up period of 5.5 years the results were 36.7% satisfactory and 63.3% unsatisfactory