For evaluating pelvic support osteotomy as a salvage procedure in managing neglected hip problems in adolescents and young adults, PSO was performed for 20 hips in 20 patients (5 men and 15 women). The mean age was 21.5 years. The etiology was neglected developmental dysplasia of the hip in 9 patients, post-septic hip sequelae in 9 patients, and paralytic dislocation due to poliomyelitis in 2 patients. All patients were treated by two osteotomies: a proximal femoral osteotomy to support the pelvis and correct the flexion and rotational deformities of the hip and a distal varization and lengthening osteotomy. Final clinical evaluation was done 6 months after frame removal. The mean external fixation time was 6.4. Lengthening and mechanical axis parallelism was achieved in all patients. At the final follow-up and according to a predesigned scoring system, there were 7(35%) excellent results, 6(30%) good results, 7(35%) fair results, and no poor results. Hip reconstruction by Ilizarov’s concept can be technically demanding and involving lengthy period wearing the frame but found to be a valuable salvage procedure for numerous neglected hip problems particularly in young patients.

The aim of this study is to compare lengthening over an intramedullary nail to the conventional Ilizarov method with regard to percentage length increase, external fixation index, consolidation index and incidence of complications. This is a prospective randomized controlled study. Thirty-one limbs in 28 patients were included in the study; 15 were lengthened over an intramedullary nail, and 16 limbs were lengthened conventionally. The mean duration of external fixation in the lengthening over nail group was 52.2 days compared to 180.4 days in the conventional group. There was higher incidence of complications in the conventional method group. In comparison with conventional Ilizarov lengthening, lengthening over an intramedullary nail offers a shorter period of external fixation and fewer complications overall, but there is a high incidence of deep intramedullary infection which is serious.

Background: Lesions of the upper trunk in obstetric brachial plexus palsy (OBPP) commonly leads to long-term shoulder dysfunction. The constant internal rotation lead to early glenohumeral (GH) joint deformity by 6 mo of age and to advanced deformity by 2 yr. Halting or reversing GH deformity and the percentage of the humeral head anterior to the midscapular line is an important surgical goal to restore shoulder function. The purpose of this study was to assess the ability of arthroscopic anterior release (with or without tendon transfers) to correct GH deformity. Methods: Twenty-one patients were included in this study. The average age was 26 mo (17 to 50 mo). Sixteen patients (76.2%) had C5 or 6 lesion, while five (23.8%) had C5, 6 or 7 lesion. Seven patients had grade II GH deformity (33.3%), ten had grade III (47.6%), and four had grade IV (19.1%). Ten children underwent isolated release and 11 underwent concomitant tendon transfers. Functional and radiographic assessments were used to assess outcome after at least 1-year follow-up. The average follow-up period was 19±7 mo (range 12-41 mo). Results: Significant improvement was noted in both the glenohumeral retroversion angle (GRV) angle and percentage of humeral head anterior to the midscapular line at 1-year follow-up The mean preoperative GRV angle was −27.8 degrees and postoperatively −11.8 degrees. The mean percentage of humeral head anterior to the midscapular line was 25% preoperatively and 43% postoperatively. Aggregate Mallet score also demonstrated statistically significant improvement. Conclusions: Arthroscopic release and reduction of GH joint with or without tendon transfer for the sequela of OBPP was associated with GH remodeling. The current study confirmed that the improvement was achieved after nearly 1-year follow-up. The clinical improvements paralleled the radiographic ones. Level of evidence: IV.

Background Osteogenesis imperfecta is a group of heterogeneous disorders with a common characteristic of congenital bone fragility caused by mutations in genes encoding procollagen type I. (COL1A1 and COL1A2). Objectives This study aims to review the outcomes of the use of different generations of telescopic intramedullary nails in lower limbs for management of children with osteogenesis imperfecta (OI) and evaluate the functional outcomes of them. Patients and Methods Methodology: Criteria for considering studies for this review, types of studies: we will include: case series studies, retrospective cohort studies and we will exclude: case reports, cross sectional studies, non English studies. Search results will be conducted to systematic review management software and manually screened for eligibility to be included. PRISMA flowchart will be produced based on the search results and the inclusion/ exclusion criteria. Results One of the highest complications that have been very challenging for the orthopedic surgeons is migration and displacement of the telescopic intramedullary nails and FassierDuval nail has showed to have the lowest migration and displacement incidence rate (10.3%) which was clinically significant according to our statistics which supports the previous literature. On the other hand according to our statistics we found that there is no statistical significance in the cortical perforation of the telescopic nails between the different generations despite it might have been thought before that Bailey-Dubow nail has higher cortical perforation rate as the P value = 0.413. Post operative fractures and telescopic nail bending have shown no statistical significance according to our statistics which differ from each study when taken separately with P value = 0.252 and P value = 0.059 respectively. For the bending results we think that more studies are needed to increase the number of patients as it might show statistical significance according to its P value. Conclusion Fassier-Duval telescopic nail has good outcomes with the least complication rates and a promising generation of telescopic nail but needs a multicenter randomized control trials to conduct a level I evidence based on meta-analysis.