Introduction: Meniscal tears are common in young athletes, usually result from a twisting injury during sport and may occur in the anterior or posterior horns. Injured menisci may be treated arthroscopically by excision of the torn fragments. However, in patients with peripheral meniscal detachment, located at the “vascular zone”, operative repair is feasible and usually successful. Meniscal repair may be done by open direct suture of peripheral tears or by arthroscopic techniques as “Outside-In”, “Inside-Out” or “All-Inside”. We present our experience with arthroscopic suture of completely detached menisci.

Patients & Methods: This study consisted of 33 male patients (14-48Y; mean 25Y; Follow-up: 2-6Y; mean 3.5Y). Inside-Out technique was used in 31 patients and Outside-In technique in two patients. 16/33 patients had detachment of the peripheral half of the meniscus (14-medial; 2-lateral); 13/33 patients had peripheral detachment of almost two thirds of meniscus (10-medial; 3-lateral) and 4/33 patients had detachment of one third of the meniscus (3-lateral; 1-medial injuries; all combined with fractures of the tibial plateau). 15 patients with medial meniscus detachment had complete (5 Pts) or partial (10 Pts) tear of ACL. Two other patients with medial meniscus detachment had associated small radial tears of the affected meniscus. Two of the patients with complete ACL tear had later been operated upon for reconstruction of ACL. Results were assessed by the Knee Society Knee score and by Lysholm Scoring Scale.

Results: 25/33 patients (76%) had good and excellent results. Four of them developed re-tear and detachment of medial meniscus during other later additional sport injuries, usually between 1–2 years following initial treatment. Four other patients had a “second” arthroscopic look 1–2 years later following another sport twisting injury and in all of them a stable peripheral attachment of the sutured menisci was observed. Results were better in patients who had ACL reconstruction a few months following meniscal repair. 5 patients had fair results (15%) and 3 patients had poor results (9%).

Conclusions: Based on this study it is suggested that meniscal suturing for peripheral tears is a satisfactory procedure. Meniscal tears suitable for repairs are those within the vascular zones (the outer third of the menis-cus), unstable on probing, are longer than 7mm and without major surgical damaging. Tears of posterior segments are the most difficult to suture and often require open arthrotomy. ACL reconstruction combined with meniscal repair appears to increase the healing rate of the meniscus. There are also adjuvant techniques for meniscal repair such as: fibrin clot or laser (both are weaker than suture alone) and adhesives. However, there is still not enough data.

Purpose: A retrospective study was performed in order to evaluate the results of fixation of displaced unstable fractures of both bones of the forearm in children by intramedullary pins.

Materials and methods: During the last fifteen years 121 children with displaced midshaft fractures of the forearm were treated by open or closed reduction and smooth intramedullary pin fixation. The age range was 5–16 years, the mean 11 years. Seventy five children (62%) were operated upon primarily because of an irreducible fracture, and the remaining 46 (38%) were operated upon within two weeks after failed closed reduction. The arm was then immobilized in a plaster cast extending above the elbow. The average time for fracture healing and cast removal was 8 weeks. Afterwards the children were encouraged to move the elbow and wrist joints. The hardware was removed following a period of between 6 weeks to 5 years (average 5.5 months), under sedation or general anesthesia.

Results: Follow up was available in 91 of the 121 children for between 6 months to 15 years (mean 5.5 years). Using the grading scheme of Price, functional results at follow up were excellent in 79/91 patients (87%) and good in 12/91 children (13%). There were no fair or poor results. Of them, in 80 cases (88%), within one year from injury, a full range of movement was obtained in the elbow and wrist joints. 11 patients (12%) had an average loss of 10 degree of supination. In two cases there was a neuropraxia of interosseous nerves which disappeared spontaneously within 3 months. In one patient, a 16 year old boy, there was a delayed union of 6 months until solid healing. 4 patients had a mild degree of angulation of the distal third of the forearm. There were no incidences of deep infection, nonunion or damage to the epiphyseal plate.

Conclusion: In conclusion we found that smooth intra-medullary pinning for displaced midshaft fractures of the forearm in children is a good, simple and safe method.

Aims: A retrospective study was performed in order to evaluate the results of þxation of displaced unstable fractures of both bones of the forearm in children by intramedullary pins. Methods: 121 children (5–16 year old; mean 11 years) with unstable displaced midshaft fractures of the forearm were treated by smooth intra-medullary pin þxation. 75 (62%) were operated upon primarily because of an irreducible fracture. 46 (38%) were operated upon within 2 weeks after failed closed reduction. The arm was immobilized in a plaster cast extending above the elbow for about 6 weeks. Pins were removed between 6 weeks to 5 years (average 5.5 months). Results: Follow up (1Ð15 years; mean 5.5 years) was available in 91/121 children. Using the grading scheme of Price, functional results at follow up were excellent in 79/91 (87%) and good in 12/91 (13%). There were no fair or poor results. 80 Pts (88%) had within one year a full range of movement of the elbow and wrist joints. 11 Pts (12%) had an average loss of 10 degree of supination. 4 Pts. had a mild degree of angulation of the distal third of the forearm. 2 Pts had a temporary neuro-praxia of the interosseous nerves. 2 Pts had re-fractures following early removal of pins. There was one case of non union treated successfully by plating. One of the patients had a delayed union of 6 months until solid healing. One had a deep wound infection. There were no other complications. Conclusions: In conclusion we found that smooth intramedullary pinning for displaced midshaft fractures of the forearm in children is a good, simple and safe method.