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Forearm fractures are the most common fractures among children. When treating pediatric forearm fractures, the basic principle is to accurately align, angularly and rotationally, both the radius and the ulna. Both bone diaphyseal forearm fractures which are minimally displaced can be treated nonoperatively. Displaced fractures need reduction and unstable fractures after reduction need additional fixation.

Background Mirror foot is a rare anomaly and limited long term follow-up information is available. Methods Seven years after operation a mirror foot patient returned with foot complaints and was evaluated using radiographs and clinical examination. A systematic literature search was conducted to study foot complaints in mirror feet. Results Different origins of foot pain were considered in our patient; tibia length difference, deformed talus and accessory osseous structures in the tarsal region. Literature search resulted in 118 mirror feet. Based on cases reporting osseous structures, 74.2% showed tibia abnormalities and 94.5% an abnormal tarsal region. Only three cases mentioned a normal talus. Nine cases reported a follow-up period of more than five years. Conclusion Osseous abnormalities are not always visible at birth, but are often present. Therefore, detailed examination of the affected limb in mirror foot patients with foot pain is important, in order to localize the origin.

Introduction Treatment of proximal humeral fractures with plate osteosynthesis or intramedullary nail fixation in humeral shaft fractures with a proximal locking bolt carries the risk of iatrogenic injury of the axillary nerve. The purpose of this anatomical study is to define a more reliable safe zone to prevent iatrogenic axillary nerve injury using the humeral head instead of the acromion as a (radiographic) reference point during operative treatment. Materials and methods Anatomical dissection and labeling of the axillary nerve and branches was performed on 10 specially embalmed human specimens. Standard AP and straight lateral radiographs were made. The distances were measured indirectly from the cranial tip of the humerus to the axillary nerve on radiographs. Results The median distance from the cranial tip of the humerus to the axillary nerve was 52 mm. The mean number of axillary nerve branches was 3. The distances from the cranial tip of the humerus to the nerve (branch) varied from 23 to 78 mm. The median distance from the proximal (anterior) branch was 36 mm, to the second branch 47 mm, 54 mm to the third branch and 73 mm to the fourth branch. The axillary nerve moves along with the humerus in cranial and caudal direction when the subacromial space varies. Conclusion This study shows that the position of the axillary nerve can be better determent using the cranial tip of the humerus as a reference point instead of the acromion. Furthermore, it is unsafe to place the proximal locking bolts in the zone between 24 mm and 78 mm from the cranial tip of the humerus. The greatest chance to cause a lesion of the main branch of the axillary nerve is in the zone between 48 mm and 58 mm caudal from the tip of the humeral head. How to cite this article Theeuwes HP, Potters JW, Bessems JHJM, et al. Use of the Humeral Head as a Reference Point to Prevent Axillary Nerve Damage during Proximal Fixation of Humeral Fractures: An Anatomical and Radiographic Study. Strategies Trauma Limb Reconstr 2020;15(2):63–68.

We report a case of a five-year-old Caucasian girl with a posterior mediastinal teratoma. She presented with scoliosis and back pain. The teratoma was fixed to several surrounding structures, such as the aorta, the left lung and the chest wall, which complicated surgical excision. All these aspects are discussed and possible explanations for the development of mediastinal teratoma's are reviewed.