Introduction: One of the problems of high tibial valgus osteotomy is the loss of achieved correction, which, in turn, is associated with the deterioration of the patient’s symptoms.

Aim: The aim of the present retrospective study is the correlation of certain parameters of axial alignment of the knee joint with the possibility of varus recurrence, after high tibial osteotomy, with stable fixation.

Material – Method: For this purpose we studied 33 patients (37 knees), that had undergone high tibial osteotomy between 1989 and 1997. All the above patients had a follow up of at least 2 years, with a mean of 35 months. The axial parameters that were studied were the femoral condyle-femoral shaft angle, the tibial plateau-tibial shaft angle, the post operative valgus correction and the post operative medial joint space widening.

Results: Loss of femorotibial angle equal to or more than 3 degrees was regarded as recurrence. This was observed in 9 knees (24%). The possibility of recurrence was strongly associated (Logistic Regression Analysis), on the one hand, with a post operative valgus correction of less than 6 degrees, and, on the other hand, with a femoral condyle-femoral shaft angle of more than 84 degrees (varus orientation of the articular surface of femoral condyles).

Conclusion: It seems that both undercorrection of the femorotibial angle and varus orientation of the femoral condyles in the frontal plane do not allow the shift of the weight bearing axis of the lower extremity towards the lateral compartment and, thus, constitute risk factors for recurrence of the varus deformity.

Introduction: Modern nailing techniques are the gold standard in the treatment of multifragmentary fractures of femur. Nevertheless, the use of plate and screws, in accordance with the principles of biologic fixation, remains an effective alternative.

Aim: The purpose of this retrospective study is the evaluation of the results of biologic fixation, with plate and screws, of multifragmentary femoral fractures.

Material – Methods: Our material consists of 32 multifragmentary subtrochanteric and diaphyseal femoral fractures that were treated in our department, between 1992 and 2000, in accordance with the principles of biologic fixation with plates and screws. All fractures were reduced indirectly with traction on the fracture table without any direct manipulation at the comminution zone. Emphasis was given to the restoration of the proper length, axial and rotational alignment of each fracture. The exposure of the femur was done proximally and distally to the fracture site through two separate incisions of the vastus lateralis near its insertion to the linea aspera. There was no direct exposure of the comminution zone. The fixation was done with a long bridge plate, without the use of interfragmentary screws. No iliac bone graft was used in the primary procedures.

Results: Twenty nine of the fractures (91%) united, without serious complications, within 3–5 months. One fracture failed to unite and had to be operated upon with a new plate and screws and additional bone grafting. In another one, the plate was bent, due to early weight bearing, and had to be exchanged with a nail. The third fracture united in a mild varus position, as some of the screws were broken and the plate was mildly bent.

Conclusions: The bio-“logic” use of plate and screws in the treatment of multifragmentary fractures of femur gives excellent results, comparable with those of the modern nailing techniques.

Purpose: The aim of this study is the evaluation of the use of plate and screws without restoration of the opposite cortex and without the use of bone graft in the treatment of multifragmentary fractures of femur.

Material and Methods: For this purpose, we retrospectively studied 26 multifragmentary femoral fractures that were treated in our department in accordance with the above principles, between 1992 and 2001. All fractures were reduced indirectly with traction on the fracture table without any direct manipulation at the comminution zone. Emphasis was given to the restoration of the proper length, axial and rotational alignment of each fracture. The fixation was done with a long bridge plate, without the use of interfragmentary screws.

Twenty five of the fractures (96.5%) united, without any serious complication, within 3–5 months. In one fracture the fixation failed and had to be revised.

Conclusions: The use of plate and screws in the treatment of multifragmentary fractures of femur, once it is done with complete respect to the fracture biology leads to speedy fracture union, high union rate and a very low complication rate.