The described technique allows reconstruction of the MPFL in skeletally immature patients with ligament laxity avoiding any potential risks of growth disturbances or chondral damage as compared to other techniques. The modification of two-point femoral fixation allows both a more anatomic and more secure form of reconstruction and is cost-effective without the need for hardware.

IV.

Background:Giant cell tumors (GCTs) of bone are aggressive benign tumors. Wide resection is reserved for a small subset of patients with biologically more aggressive, recurrent, and extensive tumors. Wide resection and mobile joint reconstruction are preferable for treating tumors around the knee. In certain situations, resection arthrodesis or an amputation is suggested. In this prospective study we report the outcome of 8 patients of aggressive GCT of lower end of femur treated with resection arthrodesis.Materials and Methods:Eight patients with mean age of 37.25 years (range 30–45 years) with Campanacci Grade III (Enneking stage III) giant cell tumors at the distal femur were treated with wide resection and arthrodesis using dual free fibular graft and locked intramedullary nail from January 2003 to January 2008. There were four males and four females patients. The mean follow-up was 48.75 months (range 30–60 months). The functional evaluation was done using the standard system of musculoskeletal tumor society with its modification developed by Enneking et al.Results:At the final follow up the functional score ranged from 20 to 27 out of total score of 30. Graft union was achieved in all cases in a duration mean of 14.5 months (range 12-20 months).One case required secondary bone graft due to delayed union, and one case had superficial wound infection which healed on systemic antibiotics. At final followup, all the patients were disease free.Conclusion:Wide resection and arthrodesis in aggressive GCTs of the distal femur with involvement of all muscle compartments is a good treatment option. Resection arthrodesis offers a biological reconstruction alternative to amputation in a special group of patients when extensive resection precludes mobile joint reconstruction.

No abstract

Shoulder hemiarthroplasty is a salvage treatment for comminuted fracture of the humerus especially in elderly patients. Several factors contribute to the final outcome like bone quality and tuberosity reposition. Timing of the surgery is considered one of these factors. This study was done to assess the effect of delaying the surgery up to 2 weeks on the final outcome. This retrospective study was done on 33 patients with four-part fracture of the humerus, divided into two groups, group 1 (17 patients) who had surgery within the first 3 days after trauma, and group 2 (16 patients) who had surgery within the second week after injury. Operations were done by the same surgeon, same technique, and same implant. Constant score was used to assess the final follow-up, and there was a significant better result for group one especially in the items of range of movements and power.