Purpose of the study: This prospective anatomic study was conducted to analyze meniscal healing after arthroscopic repair.

Material and method: Two preliminary studies (a radio-anatomic study and a comparative arthroscan-arthros-copy study) were conducted to define strict radiological criteria (contiguous slices or spiral acquisition)which could be interpreted by all observers. Sixty-five vertical meniscal lesions were included in the study and divided into four groups according to localization (medial or lateral) and knee stability (stable or associated ligamentoplasty). Arthroscopic repair was performed in all cases. Mean length of the lesions was 20.31±6 mm. Minimum follow-up was six months. The work-up included an arthroscan and the IKDC function score.

Results: The work-up could be interpreted for 62 knees. The overall outcome according to Henning was: 42% complete healing, 31% incomplete, 27% failure. Healing outcome was similar for lesion in a red-red zone (73%) or a red-white zone (70%). The healing surface could be assess for 43 knees: 37% complete healing, 21% partial healing of more than half of the initial tear, 12% partial healing of less than half of the tear, and 12% failure. The analytic results of 17 medial repairs on stable knees yielded: 9 complete, 2 partial, 4 failure, with IKDC (79, 68, 73 points) having no significant influence. For the 24 medial repairs on unstable knees outcome was: complete healing in 10, partial in 6 and a good IKDC score (80.85 points). Functional outcome was poor for the eight failures (67 points). Lateral repairs on 11 stable knees yielded: complete healing in 2 (IKDC 76 points), partial in four (IKDC 94 points) and failure in five (IKDC 82 points). For the ten unstable knees, complete healing was achieved in five and partial healing in five with good patient satisfaction (IKDC 80.70 points).

Conclusion: Methodologically, arthroscan provided a good assessment of healing. The notion of the healing surface appears to be more appropriate than thickness, since partial healing can transform an unstable knee into a stable one. Clinically, in one third of the knees, meniscal healing could not be achieved. This failure was more frequent and less well tolerated for the medial lesions. For the lateral lesions, incomplete healing was more frequent, perhaps in relation to meniscal mobility and the associated ligamentoplasty which apparently protected the meniscal repair. In this series, meniscal healing did not have a significant influence on the functional outcome.

Purpose of the study: To analyse the ability of Blount’s technique (closed reduction and immobilisation with a collar and cuff sling) for the treatment of completely displaced extension-type (Gartland III) supracondylar fracture of the humerus in children.

Introduction: Blount’s technique is usually considered to be unreliable for completely displaced extension-type supracondylar fracture of the humerus. According to the literature, it increases the risks of secondary displacement and neurovascular complications. Consequently, many authors prefer traction or internal fixation with K-wires. Nevertheless, some authors stated that Blount’s technique can be efficient in selected cases of type-III fractures. As we usually used Blount’s technique in our Institution even in cases of type-III fractures we decided to analyse our results.

Material and method: we evaluated retrospectively 46 consecutive cases of completely displaced supracondylar fractures of the humerus treated in our Institution. Mean age was 7 years (3–11). There were 31 left side and 15 right side, 35 males and 11 females. 7 patients who had associated fracture of the forearm or neurovascular damage were treated surgically and stabilised with pins. In 39 patients where the fracture was isolated without initial neurovascular complication, closed reduction under general anesthesia and stabilization with a collar according to Blount’s technique was first attempted. Results: Among the 39 patients where Blount’s technique was used, external reduction failed in 8 cases (in 5 cases, the reduction was not satisfactory, and in 3 cases, the reduction was unstable). These 8 patients were operated during the same anesthesia. Reduction and stabilisation was achieved by open reduction and pinning. Among the remaining 31 patients where closed reduction and external stabilisation could be achieved, we did not note any neurovascular complication or compartment syndrome. 8 days postoperatively, secondary displacement was noted in 2 patients. These 2 patients had operative treatment. The 29 remaining patients were reviewed with a mean follow-up of 29 months (2–6 years). Consolidation was obtained between 30 and 45 days in all cases. At the final follow-up, according to Flynn’s overall modified classification, the clinical result was considered to be excellent in 26 patients and good in 3 patients where a 10° limitation of flexion was noted. The carrying angle was identical to the controlateral side in all cases. Radiographic assessment using Baumann angle was normal in all 29 cases (65° to 75°).

Conclusion: Blount’s technique can be used in selected cases of completely displaced extension-type supracondylar fractures of the humerus in children. It appears to be safe and reliable if a perfect and stable initial reduction can be obtained.