Upper Limb lengthening in children and adolescents using monoiaterai fixators

Upper limb lengthening is indicated in large length discrepancies, severe angular deformities due to exostosis, trauma to the epiphyseal plate or congenital deficiency, which may result in functional and cosmetic problems. In our work, 8 upper limb segments in 8 patients were lengthened, which included 6 ulnae, 1 radius and 1 humerus. The cases included 3 patients with multiple hereditary osteochondromatosis, 2 patients with congenital short ulna and dislocated head radius and 2 post-traumatic patients with [pbyseal injuries and old fractures] and one patient with Ollier's disease. The average age at the time of surgery was 11.5 years [range 5-19]. In all cases the Orthofix Limb reconstruction system LRS [pediatric size] was used. Callotasis method was applied. The average follow up period was 19.5 months [range 6- 44]. The average lengthening achieved was 3 cm [range 2.3-5]. The percentage increase over initial length averaged 20% [range 15-31%]. The healing index [HI] averaged 45.7 days/cm. In one case callus deformity occurred and temporary decrease of the radio-carpal joint mobility occurred in another case. In conclusion, the results of our work on upper limb lengthening as regards the functional and aesthetic out come, the complication rate and the healing [HI] index were satisfactory

Salter innominate osteotomy in the treatment of Legg-Calve-Perthes disease [L.C.P.D]. A short follow-up study

The Goal of any surgeon treating L.C.P.D. is to improve upon the natural history of the disease. Containment whether surgical or non-surgical has evolved as an effective line of treatment in achieving such goal. Salter's innominate osteotomy improves containment by redirecting the acetabulum such that the soft plastic femoral head is protected within the solid confines of the acetabulum in the weight bearing position. Eventually when healing is over, a round non-deformed head is the likely result. This is a report on the short-term results of salter's innominate osteotomy [done in conjunction with full adductor myotomy and iliopsoas recession] performed at the new children hopital of Cairo University. The material of this study included 25 patients with L.C.P.D. [21 males 4 females] who were treated at an average age of 7.6 years [range 6.5 y-12y]. All patients had total involvement of the femoral head with or without head at risk signs. The period of follow-up averaged 30 months [range 24-54 months]. Assessment both clinically and radiologically [using Stulberg classification] was done at the final follow-up there were 19 satisfactory hips [Stulberg class 1 and 2]. We conclude that Salter's innominate osteotomy is an effective procedure in achieving containment in L.C.P.D. and hence bettering the natural history of the disease provided some pitfalls are avoided