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Introduction: Conservative management of femoral fractures in children in the preschool age is considered as the standard care. In the past years, there is an increase in the number of surgically treated children with IM nails, even in these young ages. Several papers report on the results comparing the final alignment of the fractures but there are no reports on the conservative treatment of a fracture with transposition of the fragments. Case Report: A 3-year-old boy was referred in our hospital with a spiral fracture of his right femur. There was transposition of the fragments, with the proximal part shifted medially and the distal part laterally. We informed the parents for the methods of treatment available for his fracture. After 1 week of hospitalization, the child was transferred home, with skin traction, with supervision of an orthopedic surgeon. The child was regularly evaluated with radiological examination, every 10 days. There was an uneventful healing of the fracture, with normal alignment of the leg and acceptable initial leg length discrepancy (LLD). One year after the fracture, there is an impressive remodeling of the fracture with restoration of the medullary canal and absent LLD. Conclusion: Conservative treatment of spiral fracture in a child younger than 3 years is an effective method. Remodeling in this young age can restore not only deviations on the frontal and sagittal plane but also correct the transposition of the fragments with restoration of the medullary canal.

Introduction: Solitary osteochondromas are extremely rare in the bones of the foot. In the growing skeleton, few cases affecting the metatarsals and the talus have been reported. At present, there have been no reports of osteochondromas affecting the cuneiforms. Case Report: We report the case of a 13-year-old male patient. He presented with marked prominences in the plantar surface of his left foot and pain while participating in sporting activities. Radiological examination with X-rays, computed tomography (CT) scan, and magnetic resonance imaging revealed two solitary osteochondromas growing from the medial cuneiform and the head of the 1st metatarsal. The patient was treated surgically by excision of the osteochondromas. Histological examination confirmed the diagnosis of osteochondromas. He had an uneventful recovery and returned to his sporting activities. Conclusion: Solitary osteochondroma can present in the cuneiform and metatarsal of a growing adolescent. CT scan is useful for the accurate diagnosis and surgical removal of the tumor. Keywords: Osteochondroma, foot, metatarsal, cuneiform, child.

A 9‐month‐old baby presented with sudden inability to stand and unable to move his leg. Clinical examination showed edema and knee effusion. Blood tests and MRI confirmed septic knee arthritis without bone involvement. He was treated with arthroscopic lavage. He had a complete recovery and normal growth., Appropriate evaluation of clinical and laboratory findings combined with the MRI results in accurate diagnosis of septic arthritis in infants. Arthroscopic management is a convenient method, leaving a minimal scar.

Hereditary Multiple Osteochondromatosis (HMO) is characterised by the presence of multiple osteochondromas, mainly affecting the long bones. Osteochondromas are bony projections that are either sessile or pendulated in form. Isolated osteochondromas in the form of spurs have been described as occurring in the knee and the foot. Reports of thorn-like osteochondromas affecting the ribs are extremely rare. We describe the unique case of an adolescent with multiple osteochondromas affecting the long bones. While in the lower limbs they were noted to be sessile and pendulated, they had the form of excessively elongated spurs in the radius. They created pain and limitation of his activities. The surgical removal of these spurs enabled us to restore activity in the patient's dominant (right) arm.

Neurofibromatosis is often related with severe orthopaedic disorders in children. Bone lesions are rare but pose severe difficulties in management. It affects the spine and long bones. Lesions are associated either from enlargement of neurofibromas that affect the normal growth or from primary neurofibromatosis of long bones. Dystrophic scoliosis appears with short curves, with kyphosis and rotation of the apical vertebrae. Usually affect the thoracic spine, with penciling of the ribs. Surgical treatment is challenging in cases of rapid progression. Scoliosis may appear with curvatures similar to those in idiopathic scoliosis, without dysplastic changes of the vertebrae. Anterior bowing of the tibia is manifestation of NF and is distinguished from the benign posterolateral bowing. Evaluation of the medullary canal and presence of cystic lesions in the tibia is essential. Progression to pseudoarthrosis or pathologic fracture is common. Surgical management of tibial pseudoarthrosis remains a difficult procedure. Pseudoarthrosis may appear in fibula, radius or ulna but are extremely rare. Irregular eccentric bone cysts in long bones that are commonly diagnosed after a pathologic fracture, must be differentiated for NF. Malignant transformation of neurofibromas must be considered when there is rapid progression of the lesion.

Myossitis ossificans (MO) is a benign disorder characterized by heterotopic bone formation in skeletal muscle. It is divided in three types, fibrodysplasia ossificans progressive (FOP), myositis ossificans circumscripta or traumatica (MOT) and myositis ossificans without a history of trauma (non traumatic or pseudomalignant MO). Myositis ossificans is extremely rare in children younger than 10 years. We present the clinical and radiological findings of two 5-year-old children with pseudomalignant MO due to prolonged immobilization. Plain x-ray films and CT scan with their characteristic findings of mature bone in the periphery of the lesion with smooth contour and well separated from the bone, enabled us to diagnose the lesion. To the best of our knowledge, no such cases have been reported in the literature.

We present a case series of four children, younger than 3 years old, with osteoid osteoma of the lower limb. Pain and limping were the main symptoms. With careful clinical examination, we could localize the affected area. Radiological evaluation revealed cortical thickening in 3 children. On MRI examination, we found extensive edema, with normal bony cortices. The central nidus was found in 3 children. CT scan was the most accurate examination which revealed the central nidus with surrounding sclerosis. Bone scans had positive uptake in the affected area. Our patients were treated with an intralesional excision biopsy, with simultaneous radiofrequency ablation in those affected in the femur. Pathological specimens confirmed the diagnosis of osteoid osteoma. There was uneventful recovery of our patients. This case series contributes to the limited description of osteoid osteoma diagnosed and treated in very young children.

Osteochondromas, are the most common tumors of the long bones in children. Osteochondromas are extremely rare in the carpal bones. They are diagnosed in adult life, in almost all cases in the literature. We report a 7 year old boy, who presented with a hard mass on the dorsum of his hand, with decreased wrist movements. Radiological examination showed a calcified tumor of the second row of the carpal bones, with spherical shape and covered with cartilage. He was surgically treated with removal of a cartilaginous mass that was arising from the capitate. Pathology confirmed the diagnosis of an osteochondroma.