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Background: osteoarthritis of the knee associated to angular deformity is common and usually needs different modalities of surgical treatment, which save or not the original joint. Objective: to deepen into the advantages of partial fibular ostectomy combined with knee arthroscopy in patients suffering from knee ostearhrtitis and varus deformity. Methods: a search in the databases PubMed, Hinari, SciELO and Medline was done through the information locator EndNote by using the words osteoarthritis of the knee, knee arthroscopy, varus deformity, fibular ostectomy and knee osteotomy, resulting in a total of 171 articles which 47 of them were selected for review, 38 of them belong to the last five years, including seven books. Development: several kinds of varus deformities like: primary, double and triple ones were pointed out. Surgical indications were stated as well as contraindications for partial fibular ostectomy and arthroscopy. Regarding to simultaneous and combined knee arthroscopy and partial fibular ostectomy advantages and disadvantages were stated. The most complications found in literature were described. Conclusions: combined and simultaneous knee arthroscopy and partial fibular ostectomy is a useful technique for patients suffering from knee osteoarthritis and varus deformity. DeCS:KNEE JOINT; OSTEOARTHRITIS, KNEE; ARTHROPLASTY, REPLACEMENT, KNEE; FIBULA/surgery; REVIEW LITERATURE AS TOPIC.

Background: Calcaneal fractures can be high energy intra-articular injuries associated with joint depression. Challenges to fracture reduction include lateral wall blow out, medial wall overlap, comminution and central bone loss. Secondary deformity such as hindfoot varus alters foot biomechanics. Minimally invasive approaches with indirect reduction of the calcaneal tuberosity to maintain the reduction using posterior screws is routinely being used in the treatment of joint depression fractures. Biomechanically, optimum screw numbers and configuration is not known. Biomechanical studies have evaluated and proposed different screw configurations, however, it is not clear which configuration best controls varus deformity. This study aims to determine the optimum screw configuration to control varus deformity in Sanders 2B calcaneal fractures., Methods: Sawbone models were prepared to replicate Sanders type 2-B fracture, with central bone loss and comminution. 0.5cm medial wedge of the calcaneal tuberosity was removed to create varus instability. After stabilising posterior facet with a single 4mm partial threaded screw, and applied an 8 hole contoured plate to stabilise the angle of Gissane, inserted one or two 7mm cannulated partially threaded Charlotte™ (Wright Medical Technology, Inc. 5677 Airline Road Arlington, TN) Headless Multi-use Compression (under image guidance) extra screws to control varus and subsidence deformity of the fracture. Coronal plane displacement of the dissociated calcaneal tuberosity fragment relative to the body when applying 5N, 10N and 20N force was measured in millimetres (mm)., Results: 2 screws inserted (one medial screw into the sustentaculum talus from inferior to superior and, one lateral screw into the long axis anterior process) provides the least displacement (0.88±0.390 at 5N and 1.7±1.251 at 20N) and the most stable construct (p<0.05) when compared to other configurations. A single medial screw into the sustentaculum tali (conf. 3) resulted in the least stable construct and most displacement (4.04±0.971 at 5N and 11.24±7.590 at 20N) (p<0.05)., Conclusion: This study demonstrates the optimal screw configuration to resist varus in calcaneal fractures using minimally invasive techniques. Optimal stability is achieved using 2 screws; one located along the long axis of the calcaneus (varus control) and the other placed in the short axis directed towards the posterior facet of the calcaneus (control varus and subsidence). Further cadaver research would help evaluate optimal screw placement in simulated fractures to further assess reproducibility., (Copyright © 2022 SECOT. All rights reserved.)

El Juanete de Sastre es una deformidad adquirida que afecta al quinto metatarsiano y quinto dedo del pie. Se caracteriza por una prominencia lateral en la cabeza del quinto metatarsiano, con una marcada desviación medial del quinto dedo y una desviación lateral del V metatarsiano. De origen multifactorial, hablamos de una etiología micro traumática influida por posturas viciosas en dinámica, estática o sedente, por la influencia del calzado y la presencia de alteraciones biomecánicas de la extremidad inferior y pies; aunque coexisten otros factores predisponentes. Mediante un estudio observacional transversal, realizado en diferentes academias de flamenco de Andalucía, el Área Clínica de Podología de la Universidad de Sevilla y centros privados de Investigación y Podología, sobre 27 participantes (40 pies de bailaoras y 14 pies de bailaores profesionales de flamenco), se determinó que existe una prevalencia del 14.8% de Juanetes de Sastre y del 35% de quintos dedos adducto varo. En ambos casos, la prevalencia es mayor entre la población femenina. Los años de actividad (años practicando baile flamenco) influyen significativamente en la aparición de estas deformidades.The tailor’s bunion is an acquired deformity that concerns the fifth metatarsal and the fifth toe. It is defined by a lateral protuberance in the fifth metatarsal head with the fifth toe medial curvature and fifth metatarsal lateral curvature. Its origin can be derived from multiple factors as micro traumatic etiology influenced by repetitive positions in dynamics, static and sitting, shoewear´s influence and biomechanics alterations in the lower extremity and feet, although other influence factors are also found. By means of a cross-sectional and observational study carried out in different Andalusia flamenco dance academies, Podiatry Clinic of the University of Seville and podiatry’s private research centers, in 27 participants (40 women flamenco dancers´ feet and 14 men flamenco dancers´ feet). The results revealed tailor’s bunions prevalence was 14.8% and 35% of varus fifth toe. Both of them have a higher prevalence in women population. Significant differences in the presence of deformities were found according to the years of professional activity.

Introduction: Congenital talipes equino varus (club foot) is a frequent congenital deformity of the foot. The Ponseti method is the gold standard for treatment. It consists of foot manipulation with weekly serial cast, minimally invasive surgery and Dennis-Brown bar up to five years., Objective: To describe the follow-up of patients with PEVAC treated using the Ponseti method., Material and Methods: Descriptive, longitudinal study, during 2013-2019, in patients with PEVAC managed with Ponseti method. We included patients with uni- or bilateral club foot, under two years of age, without prior surgery, whose parents signed informed consent. Patients with other malformations were excluded. Serial weekly cast was placed for 4-8 weeks, a tenotomy of the Achilles tendon was performed, and cast for three more weeks; then reverse footwear with Dennis-Brown bar. The revisions were recorded at day zero, at eight weeks and every three months up to five years of age. Correction of deformity and pain on walking was assessed., Results: There were 22 patients; 17 (77.3%) corrected more than 90% of the deformity, with adequate functionality and 86.3% without pain on gait, mean follow-up 3.9 years (1-7 years); six patients relapsed (27.27%) due to poor attachment, one re-treated with cast, and five with anterior tibial transfer, all successfully., Conclusions: The club foot managed with Ponseti method corrects more than 90% of the deformity and without or minimal pain with good adherence to treatment. We had a 27.27% recurrence in our series.

La causa eficiente del pié varus equino congénito, es en la actualidad desconocida. Existen, sin embargo, múltiples teorías orientadas a la explicación de este problema : Teorías atávica y arquiterígea, de Bardeleben, 1878 y Gegenbauer, 1864. Teoría de la Falla circulatoria de Keith, 1940, y de la Displasia fetal de Streeter, 1930; Teoría de la "Flictena" de Bagg, 1920 y Bonnevie, 1934. La Miodistrofia de Middleton, 1934; La presión mecánica intrauterina de Hipócrates, Dermis Browne, etc. La acción de las bridas amniótica y de la Enfermedad ulcerosa del amnios. Ombredanne. La detención en el desarrollo embrionario. Bohm. Los factores genéticos y las causas adyuvantes que pueden obrar sobre éstos: Deficiencia de la dieta materna durante el embarazo; irradiaciones, traumas, enfermedades y drogas recibidas durante la gestación, etc.

Varus deformity of the proximal humerus in children is a little known pathology due to its low incidence of presentation. Progress has been made in recent years in understanding the possible etiology and pathophysiological causes. Radiological criteria for diagnosis and functional impairment that occurs have also been defined. However, there are few reports in the literature about the surgical treatment of this deformity in children. In this paper we present a case of surgical treatment of this deformity by corrective osteotomy fixed with precontoured external maleolar plate osteosynthesis., (Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.)

The most frequent foot and ankle anatomical alterations in the pediatric population are found in the little toes. Several treatments are proposed for these conditions, ranging from total phalangeal resections, phalangeal osteotomies, osteosynthesis, and soft tissue management. We propose a surgical technique based on the diaphysectomy of the proximal phalanx and the release of soft tissues that are under tension. The purpose is to assess the functional foot results after surgical treatment consisting of proximal phalanx diaphysectomy and soft tissue release using the functional AOFAS scale in pediatric patients. A prospective, longitudinal, descriptive, non-comparative clinical study was conducted from March 2008 to December 2010, with a follow-up of up to six months. Twenty patients (35 toes) were included; 15 females and five males, with a mean age of 14.65 years. Fifteen (30 toes) had bilateral involvement; 88.56% had greater involvement of the fifth toe. The surgical indication was determined based on the degree of functional disability for gait and the type of footwear. The functional assessment was conducted using the AOFAS criteria and a subjective assessment scale with a total score of 100 to assess the metatarsophalangeal and the interphalangeal joints of the smallest toes. Scores were as follows: < 50 points, poor; 51-70 points, fair; 71-90, good, and > 91, excellent. The assessment was done preoperatively and at postoperative month six. The mean preoperative score was 73.55 and the mean postoperative score was 85.75, with a 12.2 point difference (p > 0.5). Results were: 11 excellent, seven good and two fair. There were four relapses, so a salvage procedure was performed with the Ruiz-Mora technique; excellent results were obtained in all four. One case had soft tissue infection. Proximal phalanx diaphysectomy and soft tissue release provides appropriate alignment of the affected toes and relief of soft tissues under tension, thus avoiding broad resections leading to both esthetic and functional alterations. This is a simple and effective technique for the treatment of little toe deformities as it improves function and alignment.

While options for operative treatment of leg axis varus malalignment in patients with medial gonarthrosis include several established procedures, such as unicompartmental knee arthroplasty (UKA), total knee arthroplasty (TKA), or high tibial osteotomy (HTO), so far there has been little focus on a less invasive option introduced more recently: the UniSpacer™ implant, a modern, self-centering, metallic interpositional device for the knee. This study evaluates whether alignment correction can be achieved by UniSpacer™ arthroplasty as well as alignment change in the first 5 postoperative years is evaluated. Antero-posterior long leg stance radiographs of 15 legs were digitally analyzed to assess alignment change: two relevant angles and the deviation of the mechanical axis of the leg were analyzed before and after surgery. Additionally, the change of the postoperative alignment was determined one and five years postoperatively. Analyzing the mechanical tibiofemoral angle, a significant leg axis correction was achieved, with a mean valgus change of 4.7±1.9°; a varus change occurred in the first postoperative year, while there was no significant further change of alignment seen five years after surgery. The UniSpacer™ corrects malalignment in patients with medial gonarthrosis; however, a likely postoperative change in alignment due to implant adaptation to the joint must be considered before implantation., (Copyright © 2012 SECOT. Published by Elsevier Espana. All rights reserved.)

Objective: To evaluate the clinical course of patients subjected to the osteotomy designed at the National Rehabilitation Institute (LP-INR) with a memory staple to treat the congenital quintus varus supraductus deformity, from December 2002 to August 2009. Moreover, to show that the LP-INR osteotomy decreases weight bearing under the 5th metatarsal head, descends the phalanx, spares the metatarsophalangeal joint, and prevents relapses and pain., Material and Methods: The study was conducted from December 2002 to August 2009 and included 51 patients with quintus varus supra-ductus deformity and 78 feet; 33 patients were males (64.7%) and 18 were females (35.2%), the Maryland clinical scale was applied at postoperative month six. The AOFAS scale was applied in the preoperative and postoperative periods to assess pain, gait and alignment., Results: The Maryland scale showed excellent results in 42 patients (84.3%), good results in 3 patients (5.8%), fair in 3 patients (5.8%) with a score of 75 to 50, and poor in 3 patients (5.8%). The AOFAS scale score for the forefoot was 55 + 8 preoperatively and 90 + 5 postoperatively. The Student t test was statistically significant in the preoperative and postoperative periods < 0.05., Discussion: The LP-INR osteotomy for the treatment of the congenital quintus varus supraductus deformity provides appropriate alignment of the 5th toe with decreased load on the 5th metatarsal head and avoids broad resections that result in both cosmetic and functional alterations.

Mrozkowiak Mirosław. Deskrypcja kąta szpotawości i koślawości piątego palca stóp dzieci i młodzieży w wieku od 4 do 18 lat w świetle mory projekcyjnej = Description the varus and valgus angle on the fifth finger of the foot of children and youth aged 4 to 18 years in the light of the moiré projection. Journal of Education, Health and Sport. 2015;5(9):245-260. ISSN 2391-8306. DOI10.5281/zenodo.30538 http://dx.doi.org/10.5281/zenodo.30538 http://ojs.ukw.edu.pl/index.php/johs/article/view/2015%3B5%289%29%3A245-260 https://pbn.nauka.gov.pl/works/620061 Formerly Journal of Health Sciences. ISSN 1429-9623 / 2300-665X. Archives 2011–2014http://journal.rsw.edu.pl/index.php/JHS/issue/archive Deklaracja. Specyfika i zawartość merytoryczna czasopisma nie ulega zmianie. Zgodnie z informacją MNiSW z dnia 2 czerwca 2014 r., że w roku 2014 nie będzie przeprowadzana ocena czasopism naukowych; czasopismo o zmienionym tytule otrzymuje tyle samo punktów co na wykazie czasopism naukowych z dnia 31 grudnia 2014 r. The journal has had 5 points in Ministry of Science and Higher Education of Poland parametric evaluation. Part B item 1089. (31.12.2014). © The Author (s) 2015; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland and Radom University in Radom, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 25.08.2015. Revised 05.09.2015. Accepted: 06.09.2015. Deskrypcja kąta szpotawości i koślawości piątego palca stóp dzieci i młodzieży w wieku od 4 do 18 lat w świetle mory projekcyjnej Description the varus and valgus angle on the fifth finger of the foot of children and youth aged 4 to 18 years in the light of the moiré projection Mirosław Mrozkowiak Uniwersytet Kazimierza Wielkiego, Instytut Kultury Fizycznej Zdrowia i Turystyki w Bydgoszczy e-mail: magmar54@interia.pl strona: http://wadypostawy.republika.pl Słowa kluczowe: kąt szpotawości i koślawości palca V. Streszczenie Wstęp. Współczesny i ogólnie praktykowany tryb życia sukcesywnie ogranicza wysiłek fizyczny na rzecz sedenteryjnego modelu spędzania czasu wolnego. Destrukcyjny wpływ hipokinezy i obciążeń statycznych znajduje odzwierciedlenie w stawach kręgosłupa, barkowych, biodrowych i stóp, skutkując zaburzeniami morfologicznymi całego organizmu, bowiem zmiany te ze względy na jedność morfo-funkcjonalną całego narządu ruchu nie ograniczają się tylko do lokalnych zmian. Cel. Określenie kąta szpotawości lub koślawości palca piątego stóp w warunkach obciążenia masą własną kobiet i mężczyzn w wieku od 4 do 18 lat. Materiał i metodyka. Badaniami objęto populację 9804 kobiet i 8699 mężczyzn w wieku od 4 do 18 lat, z wybranych losowo przedszkoli i szkół regionu Warmińsko – Mazurskiego. Metodyka badań obejmowała pomiar kąta szpotawości lub koślawości piątego palca stóp. Do oceny wykorzystano stanowisko do komputerowej oceny postawy ciała, techniką mory projekcyjnej – Posturometr M. Wyniki. Wyniki badań opracowano graficznie. Przedstawiono przebieg zmian średnich wartości kąta koślawości lub szpotawości palca piątego lewej i prawej stopy płci żeńskiej i męskiej na tle zmian obojga płci. Stwierdzenia • Kąt koślawości palca V obu stóp u kobiet nie przekracza 1, u mężczyzn 1,5 stopnia. • Kąt szpotawości u kobiet i mężczyzn wykazuje nieistotną statystycznie tendencję rosnącą z okresem względnej stagnacji w wieku 12-14 lat. Key words: angle of varus and valgus finger V. Summary Introduction contemporary and generally practiced lifestyle gradually reduces the physical effort for the sedentary model of leisure. Disruptive hypokinetic and static loads is reflected in the joints of the spine, shoulder, hip and foot, resulting in morphological abnormalities of the whole organism, because these changes with regards to the unity of the morpho-functional the entire locomotor system are not limited only to local changes. Aim. Determination of the angle of Varus or valgus finger five feet in load conditions the weight of its own men and women between the ages of 4 to 18 years. Material and methods. The studies covered the population of 9804 women and 8699 men aged from 4 to 18 years of age, with a random sample of kindergartens and schools in the region of Warmia-Mazury. The research methodology involved the measurement of the angle of varus or valgus of the fifth finger of the foot. To evaluate the position was used to evaluate computer posture, moire technique-screening Posturometr M. The results. The results of the tests have been developed graphically. Describes the process of change of the angle values valgus or varus fifth finger left and right feet female and male on the background of the changes in both sexes. Determine the angle of the valgus finger V both feet in women does not exceed 1, men 1.5 degree. The angle of the varus on men and women shows a statistically insignificant trend growing out of a period of relative stagnation at the age of 12-14 years.

Desde 1987 se vienen realizando investigaciones arqueológicas en la colina de Kalkriese, en Alemania septentrional. El hallazgo de monedas y equipo militar romanos refleja una batalla entre romanos y germanos, probablemente la de Varo en el año 9 d.C. El propósito de nuestro proyecto de investigación es reconstruir el curso de la batalla. Se hace evidente que no se puede deducir la intensidad de la lucha por el número de hallazgos. Por el contrario, hemos de tener muy en cuenta los procesos posteriores a la batalla sobre el registro arqueológico, como el rescate de soldados heridos, la captura de botín por parte de los vencedores y el saqueo de los cadáveres. Este trabajo ilustra los hallazgos y las caractertísticas del yacimiento de Kalkriese, especialmente en el núcleo del ‘Oberesch’, donde se ha hallado la mayor parte de los artefactos romanos, además de una empalizada construida por los germanos para emboscar a los romanos, y una serie de hoyos que contenían los huesos de los soldados romanos caídos. Además, se presentan nuevas aproximaciones metodológicas para la interpretación de los antiguos campos de batalla. [fr] Différentes campagnes archéologiques ont été menées dans la montagne de Kalkriese, au nord de l’Allemagne, depuis 1987. Des monnaies romaines et des pièces d’équipement militaire y attestent le déroulement d’une bataille entre Romains et Germains, probablement celle de Varus en 9 p.C. L’objectif de notre projet de recherche consiste à reconstruire le déroulement de la bataille. Désormais, il est devenu clair qu’il n’est pas possible de déterminer l’intensité des combats à partir des concentrations de vestiges. Il faut en effet tenir compte de l’impact sur le registre archéologique des interventions immédiatement postérieures à la bataille elle-même, telles que la mise à l’écart des soldats blessés ou le pillage des dépouilles par les vainqueurs. Cet article présente les trouvailles et les caractéristiques du site de Kalkriese, en particulier de la zone principale de l’«Oberesch», où ont été retrouvés la plupart des objets romains ainsi que le rempart construit par les Germains pour tendre leur embuscade à l’armée romaine et une série de fosses contenant les ossements des soldats romains tués. Enfin, sont proposées de nouvelles approches méthodologiques pour l’interprétation des champs de bataille antiques.

Unlabelled: The objective of this study is to assess the clinical and radiologic results of patients with rheumatic forefoot who underwent metatarsophalangeal arthrodesis of the first ray and arthroplastic resection of the second to fifth metatarsal heads at the National Rehabilitation Institute., Material and Methods: This is a prospective comparative study of the clinical and radiological status before and after the surgical procedure; it is a descriptive, observational single-group study. From April 2006 to December 2011, 31 surgical procedures were performed in 29 female and two male patients. The SPSS 17.0 software was used for the statistical analysis. Efficacy and quality of life indicators were compared using mean comparison tests (Student t test), the indicator of patient safety by means of frequency analysis, and the comparative analysis of the occurrence of complications throughout time., Results: The mean preoperative visual analog scale score was 6.2 +/- 1.3, with an average of 1.6 +/- 2.5, with statistical significance, with p < 0.0001 and t = 7.97. Radiographic measurements of the hallux valgus angle showed a remarkable improvement., Conclusions: The surgical procedure described is reliable and efficacious, as patients had an important improvement in quality of life, with pain relief and adaptation to their activities of daily living after surgery.

Introduction: Tibial stress fractures are a very common condition in military recruits. Our objective is to demonstrate that stress fractures are associated with other diseases. Materials and Methods: 42 stress fractures in 34 patients were retrospectively evaluated. Every patient had recently joined the Argentine Army and consulted for painful symptoms in the tibia. A clinical and scintigraphic diagnosis of stress fracture was made. Patient data, associated diseases, and risk factors were documented. Inclusion criteria: recent incorporation, same training, age between 16 and 23 years. Trauma, simulators, tumoral pathology, and cases with negative scintigraphy were excluded. Results: We studied 42 stress fractures in 34 patients, 14 were men and 20 were women. The average age was 20 years. There were no significant differences in the number of injuries regarding the affected limb. 64.7% had associated diseases, 73% in women and 27 % in men. Among the women with stress fractures, 80% had associated diseases, compared to 43% for men. Different diseases were found with lower limb varus and valgus imbalances. Varus was the most associated with fractures. Conclusions: A high rate of associated diseases was found in patients with tibial stress fractures with a predominance of lower limb varus imbalances. Associated diseases were more likely to be found in women with stress fractures than in men.

Resumen: Introducción: Las fracturas de cóndilo humeral lateral (FCHL) representan del 12 al 17% de las fracturas de codo pediátrico. La asociación de esta fractura con luxación de codo es poco común, siendo escasa la bibliografía y generalmente limitada a reportes de casos. Nuestro objetivo fue revisar sistemáticamente la literatura sobre las fracturas del cóndilo lateral del húmero asociadas a luxación de codo en niños. Métodos: Se realizó una revisión sistemática mediante una búsqueda exhaustiva en las bases de datos PubMed y Embase de literatura revisada por pares entre 1960 y 2020. Dos revisores filtraron los resultados y buscaron artículos en inglés o español que reportan pacientes esqueléticamente inmaduros con fracturas del cóndilo lateral del húmero asociadas a luxación de codo. Los resultados analizados incluyeron características del paciente y de la lesión, estrategias de tratamiento, complicaciones y resultados finales. Resultados: La búsqueda inicial arrojó un total de 851 estudios. Después de la revisión, se incluyeron 16 estudios, con 67 pacientes disponibles para revisión. Las edades reportadas al momento de la lesión variaron entre 2 y 12 años. La lesión se presentó más comúnmente en varones con fracturas tipo Milch II, Jakob tipo 3. La dirección de la luxación fue posteromedial en la mayoría de los casos. La reducción abierta por abordaje lateral y la colocación de clavijas Kirschner fue el tratamiento más comúnmente realizado. El seguimiento reportado se presentó en un rango 3 a 156 meses. Catorce estudios informaron complicaciones en un tercio de los pacientes, que incluyen: limitación del rango de movimiento, cúbito varo, inestabilidad, prominencia del implante, retraso de la consolidación, seudoartrosis, consolidación viciosa, osificación heterotópica, lesión neurológica y fallo del implante. Trece estudios informaron resultados clínicos, que se calificaron como regulares o pobres en 2 de cada 10 pacientes. Conclusiones: La evidencia actual es nivel iv y sugiere que la tasa de complicaciones después del manejo quirúrgico de las fracturas de cóndilo lateral es elevada en el contexto de una luxación de codo, lo que se asocia además a un alto porcentaje de resultados subóptimos. Las complicaciones más frecuentes en esta serie fueron la rigidez articular y el cúbito varo. Abstract: Background: Lateral humeral condyle fractures are the second most common fracture around the elbow in children. However, the association of an elbow dislocation is a rare entity. Therefore, literature on young patients with this uncommon combination is sparse. We aimed to perform a systematic review of the literature searching for pediatric lateral condyle humerus fractures associated to elbow dislocation. Methods: A systematic review of the PubMed and Embase databases was conducted for peer-reviewed literature between 1960 and 2020. Two reviewers filtered the results, looking for articles in English and Spanish that reported fractures of the lateral condyle of the humerus associated to elbow dislocation in skeletally immature patients. Outcomes included patient and injury characteristics, treatment strategies, complications, and final outcomes including range of motion. Results: The initial search yielded a total of 851 studies. After initial screening, 16 studies were included, with 67 patients available for review. Age reported at the time of injury ranged from 2 to 12 years. The lesion occurred more commonly in males (60%) with Milch II, and Jakob type 3 fractures. The direction of the dislocation was posteromedial in most cases. Open reduction by lateral approach and Kirschner pin placement was the most performed treatment. The reported follow-up ranged from 3 to 156 months. Fourteen studies reported complications in 1/3 of the patients including: limited range of motion, cubitus varus, instability, hardware prominence, delayed union, nonunion, malunion, heterotopic ossification, neurological injury, and hardware failure. Thirteen studies reported clinical outcomes, which were rated as fair or poor in 2 out of 10 patients. Conclusions: Current evidence is level IV and suggests that the complication rate after surgical management of lateral condyle fractures is substantial in the context of an associated elbow dislocation, with an elevated percentage of suboptimal results. The most frequent complications in this series were elbow stiffness and cubitus varus.

Background: Lateral humeral condyle fractures are the second most common fracture around the elbow in children. However, the association of an elbow dislocation is a rare entity. Therefore, literature on young patients with this uncommon combination is sparse. We aimed to perform a systematic review of the literature searching for paediatric lateral condyle humerus fractures associated to elbow dislocation. Methods: A systematic review of the PubMed and Embase databases was conducted for peer-reviewed literature between 1960 and 2020. Two reviewers filtered the results, looking for articles in English and Spanish that reported fractures of the lateral condyle of the humerus associated to elbow dislocation in skeletally immature patients. Outcomes included patient and injury characteristics, treatment strategies, complications, and final outcomes including range of motion. Results: The initial search yielded a total of 851 studies. After initial screening, 16 studies were included, with 67 patients available for review. Age reported at the time of injury ranged from 2 to 12 years. The lesion occurred more commonly in males (60%) with Milch II, and Jakob type 3 fractures. The direction of the dislocation was posteromedial in most cases. Open reduction by lateral approach and Kirschner pin placement was the most performed treatment. The reported follow-up ranged from 3 to 156 months. Fourteen studies reported complications in 1/3 of the patients including: limited range of motion, cubitus varus, instability, hardware prominence, delayed union, nonunion, malunion, heterotopic ossification, neurological injury, and hardware failure. Thirteen studies reported clinical outcomes, which were rated as fair or poor in 2 out of 10 patients. Conclusions: Current evidence is level IV and suggests that the complication rate after surgical management of lateral condyle fractures is substantial in the context of an associated elbow dislocation, with an elevated percentage of suboptimal results. The most frequent complications in this series were elbow stiffness and cubitus varus. Resumen: Introducción: Las fracturas de cóndilo humeral lateral representan del 12-17% de las fracturas de codo pediátrico. La asociación de esta fractura con luxación de codo es poco común, siendo escasa la bibliografía y generalmente limitada a reportes de casos. Nuestro objetivo fue revisar sistemáticamente la literatura sobre las fracturas del cóndilo lateral del húmero asociadas a luxación de codo en niños. Métodos: Se realizó una revisión sistemática mediante una búsqueda exhaustiva en las bases de datos PubMed y Embase de literatura revisada por pares entre 1960 y 2020. Dos revisores filtraron los resultados y buscaron artículos en inglés o español que reportan pacientes esqueléticamente inmaduros con fracturas del cóndilo lateral del húmero asociadas a luxación de codo. Los resultados analizados incluyeron características del paciente y de la lesión, estrategias de tratamiento, complicaciones y resultados finales. Resultados: La búsqueda inicial arrojó un total de 851 estudios. Después de la revisión, se incluyeron 16 estudios, con 67 pacientes disponibles para revisión. Las edades reportadas al momento de la lesión variaron entre 2 y 12 años. La lesión se presentó más comúnmente en varones con fracturas tipo Milch II, Jakob tipo 3. La dirección de la luxación fue posteromedial en la mayoría de los casos. La reducción abierta por abordaje lateral y la colocación de clavijas Kirschner fue el tratamiento más comúnmente realizado. El seguimiento reportado se presentó en un rango 3-156 meses. Catorce estudios informaron complicaciones en un tercio de los pacientes, que incluyen: limitación del rango de movimiento, cúbito varo, inestabilidad, prominencia del implante, retraso de la consolidación, seudoartrosis, consolidación viciosa, osificación heterotópica, lesión neurológica y fallo del implante. Trece estudios informaron resultados clínicos, que se calificaron como regulares o pobres en 2 de cada 10 pacientes. Conclusiones: La evidencia actual es nivel iv e indica que la tasa de complicaciones después del manejo quirúrgico de las fracturas de cóndilo lateral es elevada en el contexto de una luxación de codo, lo que se asocia además a un alto porcentaje de resultados subóptimos. Las complicaciones más frecuentes en esta serie fueron la rigidez articular y el cúbito varo.

Background: knee is one of the joints most affected by osteoarthritis, associated to angular deformities especially the varus, which makes treatment even more difficult. Objective: to show a case report of a patient with knee osteoarthritis and varus deformity treated by simultaneous arthroscopy and proximal fibular ostectomy. Clinical case: a 64 year-old, white woman, without health morbid antecedents, was taken to the outpatient department complaining of left knee pain for a year, the pain gets worse with physical activities and reliefs with rest, pain killers and non steroidal anti-inflammatory drugs. Simple X Rays showed varus deformity of both knees more accentuated in the left one. Because of patient condition, she underwent surgery where it was performed a combined and simultaneous arthroscopy and proximal fibular ostectomy. Conclusions: the technique is a useful, while combining two procedures in one, and it is feasible and reproducible in institutions with arthroscopic service training. DeCS: OSTEOARTHRITIS, KNEE; GENU VARUM/surgery; ARTHROSCOPY/methods; OSTEOTOMY /methods; FIBULA /surgery.

Introduction. Faulty posture, overweight and obesity are one of the most common health problems in Poland among children and adolescents. Although posture disorders are usually commonly diagnosed, the occurrence of polyarticular hypermobility is rarely taken into account when planning corrective exercises. The aim of the study was to assess the influence of hypermobility on the occurrence of lower limb defects. Materials and methods. The study included 35 children (14 girls and 21 boys) aged 6-10 years with diagnosed in a Beighton test hypermobility . The control group also consisted of 35 children of the same age and the same number of girls and boys. Using the calipers and the goniometer, the valgus, varus or hyperextension of the knee joints, valgus and varus of the ankles as well as flat feet have been assessed. Then, the results obtained in the hypermobility and control group were compared. Results. There were statistically significant differences (p = 0.001) in the occurrence of most defects of the lower limbs in children with hypermobility in relation to healthy ones. For knee valgus, the rho-Spearman correlation was r = 0.611; for deformity of the knees r = 0.56; for knee hyperextension r = 0.52; for flat feet r = 0.628; for valgity of feet r = 0.555. In the examined groups, no varus deformation was observed. Conclusions.1.Hypermobility predisposes to the occurrence of lower limb defects in children. 2. There is an indication for performing screening tests in children of early school age and implementation of prevention programs for polyarthritis hypermobility.

Purpose: The SL-Plus cementless stem was introduced in 1993 as an evolution of the Alloclassic® stem with some modifications. The aim of this study was to analyse if these modifications have any influence in clinical and radiological outcomes at minimum 10-year follow-up., Methods: Sixty-eight consecutive implants (64 patients) were retrospective evaluated. The mean duration of clinical and radiographic follow-up was 12.2 years. There were 41 female and 23 male patients with a median age of 73.5 years. All complications and reinterventions were collected. Functional outcomes were assessed using the modified Harris Hip Score (mHHS). Radiographs were evaluated immediately after the operation, after a minimum 2-year follow-up and by the end of follow-up (time A, B and C, respectively)., Results: Two stems were revised, one due to periprosthetic fracture and one due to aseptic loosening with a cumulative probability of not having a stem revision for any reason of 97.2% at 12.2 years. Mean mHHS was 76.7 points at the latest follow-up. Significant differences were found in distal migration (time A: 5.9mm±6.7; B: 6.9mm±7.1 and C: 8.2mm±6.3; P=.000) and varus angulation (time A: 0.0°±2: B: 0.0°±2 and C: 1.0°±3; P<.001), although these stems showed radiographic signs of osseointegration. Thirty-three hips (48.5%) showed any radiolucent line around the stem, most of them located the proximal femur (Gruen 1 and 7). Multivariate regression analysis showed lower mHHS scores in older patients (P=.004) and female (P=.00)., Conclusions: The modifications of the SL-Plus stem influence the long-term outcome of the implant regarding radiological results, particularly in progressive varus angulation and distal migration. However, our study has not been able to demonstrate any clinical repercussions: functional scores and survival free of all cause revision were favorable and comparable to previous reports., (Copyright © 2024 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)

El cubito varo es la secuela más frecuente en las fracturas supracondíleas de humero en la población pediátrica, objetivo analizar los diferentes tipos de osteotomías y los métodos fijación para el tratamiento de estas lesiones. Materiales y métodos: se realizo una búsqueda bibliográfica utilizando como motor de búsqueda la plataforma Pubmed y OVID, las palabras claves fueron Cubitus AND varus AND osteotomy. Resultados: se seleccionaron 13 artículos, con un N de 237 pacientes, follow-up de 30 meses, edad al momento de la cirugía fue 8,78 años. La técnica de osteotomía más utilizada fue la de cierre lateral. 35.4% se fijaron con placas, 24.8% con fijadores externos y 33.3% fijación con kw/pins. Conclusión: las técnicas de osteotomías utilizadas actualmente logran corrección angular. No se encontraron diferencias significativas entre los resultados de las técnicas analizadas. No existe un implante que sea superior a otro a la hora de realizar la fijación de las osteotomías de humero distal. Cada implante tiene ventajas y desventajas.

Introduction. Few publications have addressed the static-dynamic correlations of characteristics concerning the regions of feet and pelvic girdle. The problem was explored by Mięsowicz. Development of IT solutions allows for a more comprehensive approach to evaluation of body posture and examination of temporal and spatial relationships between individual components and evaluation of spatial balance in the vertical body posture. The aim of this study was to determine the significance of the correlation between selected characteristics that describe the system of the pelvis, spine and feet in the population of children of both sexes aged 7 to 13. Material and methods. The examinations conducted in a group of children and young people aged 7 to 13 years allowed for recording 12,898 observations, including 6,938 girls and 5,960 boys, and values of 121 characteristics that describe body posture and feet across individual age and sex categories. The test stand for evaluation of body posture and feet using the photogrammetric method is composed of a personal computer, software, screen and printer, and projection-reception device with a camera for measurement of selected parameters. Conclusions 1. The most frequent and strongest correlations and their coexistence with the characteristics in the area of feet occur in the groups of girls aged 11 and 12 years and boys aged 11, 12 and 13 years. 2. No regularities and logical relationships were found between the parameters of the pelvis-spine-feet system in any age range and any sex. • Among the characteristics which describe the pelvis-spine system and are most often correlated with feet characteristics are the characteristics of the sagittal and frontal planes, followed by less pronounced characteristics of the transverse plane. Furthermore, among the characteristics of the feet which are most often correlated with the parameters of the pelvis and spine system are the characteristics that describe valgus and varus deformities of the fifth toe and varus deformity of the hallux of the right foot.