The use of external fixation in open tibia fractures with severe soft tissue injury is the most preferred and safe treatment. The primary allograft application is doubtful due to high infection risk.

The evaluation of the results of open tibia fractures type II and III according Gustillo-Anderson that were treated with simultaneous external fixation and allograft application.

From 2005–2007, twenty nine open tibia shaft fractures in 27 patients (2 bilateral) with mean age of 35 years-old were treated.

According Gustillo-Anderson classification, there were 20 GII, 6GIIIa and 3GIIIb open tibia shaft fractures without severe bone loss. All patients were treated with thorough and extensive surgical debridment, external fixation and simultaneous application of allograft and double antibiotic scheme. The patients were followed up initially weekly till stitches removal and every second week till the external fixation removal without developing any signs of infection.

Overall, there were uncomplicated union in 23 cases (18 GII, 3GIIIa and 2GIIIb) whereas in 5 cases we had to change method of treatment (3 GII and 2GIIIa) due to union delay or non acceptable fracture angulations. There were also a case that developed deep infection and septic pseudarthrosis.

The simultaneous external fixation and allograft application seems to provide a small advantage in open fracture consolidation despite the established wisdom for allograft use on a later stage. The proper initial open fracture estimation, the right surgical treatment, the surgeon’s experience and a strict patient’s follow up schedule are fundamental for a good final outcome

To analyze the treatment results of late instability and dislocation of the hip following total hip arthroplasty.

The study refers to 16 patients from 42 to 71 years old when had primary THA. The mean time of late dislocation was 9,5 years and the revision mean time was 11 years following THA. In most patients extensive polyethylene wear was documented, in 12 patients the cup or the polyethylene insert on a stable metal implant was revised and in 4 patients new polytethylene cemented insert was placed in a stable metal implant. In all cases exchange of the femoral component metal head took place.

During follow up and re-evaluation 2–7 years after the revision there were 13 patients (81.25 %) with a stable THA and good function. Instability remained in three patients, which in 2 was resolved with re-revision of the cup whereas in the third (over aged) a special abduction brace was applied.

Late hip dislocation 5 or more years after THA occurs mainly due to extensive polyethylene wear and in contrast with early dislocation requires more often surgical intervention. The main cause of late hip dislocation was the extensive polyethylene wear, which in three cases was associated with prosthesis mal-orientation at primary implantation and in lots of cases with age-related neuromuscular deficit.

The treatment of late instability with repetitive dislocations requires surgical intervention. The revision might need exchange of cup or polyethylene insert on a stable metal implant or new polytethylene cemented insert on a stable metal implant.

Pes equinovarus is a multi-factorial congenital disease that involves 1/1000 births, is bilateral in half of the cases and affects usually male children.

From 1995 – 2008 we have treated in total 172 children with pes equinovarus, 116 male and 56 female with age from 1 week to 4 years-old. There was bilateral pes equinovarus in 36 children whereas unilateral disease revealed equal rate of incidence. All children were treated initially with corrective casts and sequentially 122 children had surgery consisting of Achilles tendon lengthening and posterior capsulotomy, whereas in the rest of the cases was necessary medial hind foot structures and tendons release.

Final correction with only one operation were achieved in 108 children, there were pes equinovarus recurrence in 18 children that was treated with new soft tissue operation whereas 3 children had to undergo some kind of osteotomy in a later time. The recurrence time varied from 30 months to 13 years. The treatment was successful in 70% of the cases and 30% of them needed more than one operation for achieving a satisfactory functional result.

Pes equinovarus is a severe condition that now-a-days can be early diagnosed even in fetal life, but leads to significant handicap if left without treatment. In our department there were successful rates similar to international reports. The importance of an established long-term follow up of children that were operated for pes equinovarus is the keystone of a successful outcome and the early treatment is mandatory.