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Background: We performed open osteoclasis, soft-tissue release, and fracture fragment reduction and fixation to treat 10 cases of neglected physeal fractures of the distal aspect of the femur with severe deformity. To our knowledge, no specific surgical procedure for this problem has been reported in the literature., Description: The procedure is typically performed through an extensile anterolateral approach. With use of an osteotome, the typically abundant fracture callus is disrupted and partially removed to recreate the original fracture line. Through periosteal dissection, an extensive musculoperiosteal detachment and release is achieved to facilitate fracture reduction while protecting the physis from further injury., Alternatives: Knee rehabilitation in closed, nondisplaced or minimally displaced fractures 1 .Open callus osteoclasis in combination with a Z-shaped quadriceps tenoplasty, reduction, and plaster cast immobilization 2 .Open subperiosteal osteoclasis, reduction, and tibial traction 3 .Open callus osteoclasis, reduction, and condylar plating 4 .Sequestrectomy with preservation of a periosteal sleeve to treat osteomyelitis complicating an open fracture 1 .Transfemoral amputation to treat gas gangrene or vascular injury following severe open injury 1,5-7 ., Rationale: This procedure was developed in remote medical facilities where patients are often first seen >21 days after the original injury. By that time, closed reduction or standard open reduction and internal fixation techniques are no longer possible. After 6 months of fracture age, the procedure is inefficient., Expected Outcomes: This procedure allows correction of limb malalignment and shortening while preserving the growth plate 1 ., Important Tips: In some cases, hypertrophic fracture callus might be mistaken for the femoral diaphysis.An extensive musculoperiosteal release will facilitate reduction of the fracture fragments.The adequacy of reduction must be assessed in all 3 planes intraoperatively.The adequacy of reduction must be assessed in all 3 planes intraoperatively.The adequacy of reduction must be assessed in all 3 planes intraoperatively., Competing Interests: Disclosure: The authors indicated that no external funding was received for any aspect of this work. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSEST/A328)., (Copyright © 2021 BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED.)

Introduction: Total hip arthroplasty (THA) has been regularly performed in the public hospital in Bobo-Dioulasso since 2010. The objective of thisstudywas to assess the medium-termresults of total hip arthroplastyat the Bobo-Dioulasso UniversityHospital. Dioulasso., Patients and Methods: This was a non-randomized single-center retrospectivestudydesigned in accordance with the recommendations of the Declaration of Helsinki. Wereviewed the medical files and evaluated 29 patients, i.e. 33 hipsoperated for THA at the Bobo-Dioulasso UniversityHospitalfromJanuary 1st, 2010 to December 31, 2015., Results: ONATF was the indication for ATH in 78.79% of cases (n = 28). THA wascementedin 43% of cases. Complications wereposterior dislocations (n = 4), infection (n = 1) and loosening (n = 2). The meanfollow-up was 78.3 months. At the last follow-up, the mean PMA was 15.13 and the mean Harris score was 84.36. The inclination of the cupswasbetween 45 ° and 50 °. The femoral stems werecenteredin 94% of cases (n = 32). There was one case of peri-prosthetic ossification and one case of acetabularrim., Conclusion: Total hip arthroplasty has become a common and well-codified practice in orthopedicsurgerywithreliable and veryencouragingresults., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)

Introduction: Neglected epiphyseal fracture-separations of the distal femur are rare. Still reported in developing countries, they lead to therapeutic issues. The objective of the study is to describe their characteristics and to propose treatment options., Materials and Methods: Ten years of ongoing study was held in our orthopedics department. All patients with a neglected epiphyseal fracture-separations of the distal femur after a knee trauma were included in the study. Pre-operative and post-operative data were collected and analyzed., Results: A total of 13 cases of neglected traumatic epiphyseal fracture-separations of the distal femur were found among 8616 in-patients of the department. It was mainly boys (9M/4F) around 16 years that were received 14 weeks after knee trauma. Most of the injuries were an AO-type 33-E/2.1 (Simple Salter-Harris' type II) (n=12) distal femur malunion (n=10). Associated complications were cutaneous opening (n=7), superficial infection (n=4), deep infection (n=4). Fractures were management surgically (n=12) by an open osteoclasis procedure (n=9), debridement (n=7) and a thigh amputation (n=1). The outcome was better if an open osteoclasis procedure was early performed in closed distal femur mal-union with a complementary rehabilitation program., Conclusion: Specialized trauma care facilities must be increased, and trauma education programs must be undertaken to avoid neglected epiphyseal fracture-separations of the distal femur in developing countries.