Missed post-traumatic radial head dislocation in a three-year-old child: A case report.

In children, traumatic radial head dislocation (RHD) is usually associated with ulnar fracture or deformation as reported in a Monteggia injury or its Monteggia variant. Isolated traumatic RHD is extremely rare and exceptional. Traumatic RHD is frequently missed on initial radiographs, particularly if it is isolated. The management of missed RHD is challenging and remains controversial. We report a Case of chronic post-traumatic RHD in a three-year-old child treated with open reduction and reconstruction of the annular ligament. The child's elbow was stable during the follow-up, without swelling or deformity, and the elbow function was normal. The injury of the reported case does not belong to any lesion described in the Monteggia-variant classification, which might explain the reason for missing the associated dislocation. The authors recommend urgent open reduction when a chronic RHD is diagnosed and annular ligament reconstruction, particularly when the open reduction is unstable.

Humeral lateral condyle fractures in children: redefining the criteria for displacement.

The aim of this study is to define paediatric lateral humeral condyle fractures prone to later displacement. The authors reviewed 106 children who were treated surgically for this fracture. There were 74 boys and 32 girls with an age range of 3-10 years. The study included 27 minimally displaced and 79 displaced fractures. The average follow-up was 50 months. Binary logistic regression model indicated that 6-8-year-old children with minimally displaced fractures and who underwent immediate surgery have a better chance for satisfactory results. The authors concluded that routine use of 2 mm displacement for treatment decisions should be changed to avoid delayed surgery.

Osteomyelitis following Bacille Calmette-Guerin vaccination.

Secondary complications after Bacille Calmette-Guerin (BCG) vaccination are unusual. We describe 3 immunocompetent children who developed osteomyelitis after BCG vaccination. The course of the disease is not dramatic, but marked changes are frequently visible in plain radiograph and MRI. The real-time polymerase chain reaction has an essential role to confirm the diagnosis of BCG osteomyelitis. With proper surgical intervention and chemotherapy, the prognosis is usually good.

Chronic isolated distal tibiofibular syndesmotic disruption: diagnosis and management.

BACKGROUND: The current study outlines the pathology and treatment of persistent problems following isolated distal tibiofibular syndesmotic injuries. METHODS: A retrospective study was conducted to review patients with isolated chronic syndesmotic disruption who were managed in the authors' institute during 4 years, from January 2001 to January 2005. Patients with concomitant bony injuries or lateral ankle instability were excluded. RESULTS: The study included eleven patients with isolated syndesmotic disruption. All were males, with average duration of symptoms 4.7 years. Reconstruction of syndesmosis was achieved by semitendinosus tendon in all patients. The average hospital stay was 3.6 days, and the average follow up period was 3.1 years. According to West Point Ankle Score system, the average score after treatment was 95.4. CONCLUSION: Chronic isolated tibiofibular syndesmotic disruption appears amenable to accurate diagnosis and delayed stabilization. Arthroscopic management of the associated intraarticular pathology followed by reconstruction of torn syndesmosis can offer an excellent outcome.