We reviewed 12 children, mean 5 (1-12) years, after corrective osteotomy of the ulna, combined with open reduction of the radial head for malunited anterior Monteggia lesions (Bado type I). A simple corrective osteotomy was used in the first 6 patients (group A) and a posterior angular osteotomy was used in the second group of 6 patients (group B). All osteotomies healed uneventfully, but 3 patients had a persistent dislocation of the radial head. Children who had been treated with an angular osteotomy had the best clinical outcome).

We describe a semi-closed method of Herbert screw fixation for acute fractures of the scaphoid. All 40 patients treated achieved solid union with satisfactory wrist function. This technique gave a significantly shorter time to union and allowed an earlier return to manual labour compared with conservative treatment. There were no complications. Semi-closed insertion requires considerable skill, but produces consistently satisfactory results after minimal exposure of the scaphoid.

Most ulnar impaction syndrome cases have characteristic focal signal intensity changes in the ulnar part of the lunate. The signal intensity often returns to normal after ulnar recession arthroplasty.

No abstract

Twenty-eight patients with perilunate dislocations that had been untreated for a minimum of 6 weeks after injury were assessed at a mean of 6.8 years after subsequent treatment. Treatment consisted of open reduction with or without internal fixation of the scaphoid in six patients, proximal row carpectomy in 16, total excision of the lunate in four, and carpal tunnel release and partial excision of the lunate in two. Open reduction yielded satisfactory results in cases of less than 2 months standing. We believe that proximal row carpectomy should be considered in the treatment of chronic perilunate dislocations in patients who are seen later than 2 months after injury, if the cartilage of the proximal pole of the capitate is well preserved. The results of lunate excision were less favourable.