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Nine frontal fractures of the humeral capitellum treated by percutaneous probe reduction are reported. Most of the fractures were percutaneously reduced with a Steinmann pin inserted along the lateral border of the biceps tendon. To prevent redisplacement of the fragment, the elbow joint was first flexed more than 90 degrees with plaster immobilization for two weeks. The favorable results obtained with this method are due to reduced surgical trauma to local tissues and good reduction of the fracture. The percutaneous probe reduction should be considered for frontal fracture of the humeral capitellum before open reduction is performed.

One hundred seven patients with fractures of the patella were treated by percutaneous suture. The method has the advantage of being simple and relatively nontraumatic. The reduction and the functional recovery were generally excellent. The reduction was poor in five cases, three of which had open reduction and internal fixation. After the percutaneous suture with steel wire is in place, the wire provides sufficient strength for internal fixation. The quadriceps expansion needs no repair. Neither open reduction nor percutaneous suture with cerclage solves the problem of the tendency of the fracture fragments to gap anteriorly. Percutaneous suture without Kirschner-wire internal fixation, with the principle of tension-band wiring, is adequate.

The basic principles for the treatment of primary vertebral tumors include radical resection of the tumor, insertion of a prosthetic vertebral body, and bone grafting within and around the prosthetic vertebral body. Since 1970, the authors have treated 12 cases with this procedure. In order to improve the vertebral prosthesis, 94 dried adult vertebral column specimens were studied. The anterior cortex of each vertebral body was thicker than the posterior cortex. The thickness of the anterior cortex of the dorsolumbar vertebral bodies progressively increases from the proximal to caudal vertebra. The lower lumbar vertebrae are therefore almost twice as thick as the upper dorsal vertebrae. The cortices of the vertebral bodies, especially the anterior cortex, serve as a strut against the pressure of the prosthesis. Four types of prostheses were used. The Type 1 prosthesis failed to take into account the anatomic features of the dorsolumbar vertebral bodies in cross section. Types 2, 3, and 4 are modified versions with specific indications for their use.