Surgical stabilization of lower limbs in osteogenesis imperfecta using modified sofield-millar operation

We present the results of intramedullary rodding of long bones of the lower limbs in children with osteogenesis imperfecta using modified Sofield-Millar operation. Fourteen patients [mean age at primary operation was 5 years 11 months] was treated with modified Sofield-Milar operation which allows minimal bone exposure. preservation of the periosteum and keeping the number of osteotomies to the minimum. Union was achieved in all cases within seven weeks. Of the 14 patients [29 bones] treated with non elongating rods, rod revisions were needed in 13 patients [26 bones]. We found no statistical significant difference between the width of the bone immediately postoperatively and at the final follow up. The walking ability was improved in 4 patients. Advantages of less invasive surgery in osteogenesis imperfecta are rapid bone union, no bone atrophy or non union, better post operative mobility and small scab

Minimally invasive fixation for treatment of fracture dislocation of the proximal humeral epiphysis in children

Fracture dislocation of the proximal humeral epiphysis in children is rare and constitutes only 3% of all epiphyseal injuries. In dealing with such fractures, there is still much controversy in treatment modalities. In this study we try to evaluate the results of treatment of proximal humeral epiphyseal fracture dislocation with open reduction and internal fixation. From 2001 to 2004, fourteen children between the age of 4 to 15 years with unstable or irreducible types of fracture dislocation of the proximal humeral epiphysis were treated with minimal exposure, open reduction and internal fixation using Rush rods or K. wires. There were 11 boys and 3 girls. The mean follow-up was 22.7 months [12 - 36]. The union rate was 100% and the average duration of union was 5.9 weeks. According to Neer's scoring system, 13 children [92.9%] had excellent results, and one child [7.1%] had satisfactory results. Occasional pain was a complaint occurs in 2 children [14.3%] and superficial wound infection was detected only in one child [7.1%]. We think that open reduction through minimal exposure and fixation with Rush rods or K. wires is an effective way to manage these unstable or irreducible fractures of the proximal humeral epiphysis as it allows more rapid rehabilitation of the shoulder motion and function