58 patients underwent treatment for Slipped Upper Femoral Epiphysis (SUFE) at our unit from 1984 to 2001. 4 (7%) patients had bilateral SUFE at the time of primary admission, 17 (29%) patients were diagnosed with a slip of the contralateral hip at review during adolescence. The remaining 37 patients whose contralateral hips were not operated upon at completion of growth were reviewed at an average follow-up of 8 years (range 2–17) after the primary admission. 13 patients were not available for review, so 24 patients were examined and their hips radiographed.

Iowa hip score was used to assess the function of the hips, Antero-posterior and lateral radiographic views were taken to look for evidence of epiphyseal slip and degenerative joint disease. The Calcar Femorale was used as a radiographic landmark to check for a slip. Ahlback’s score was used to grade osteoarthritis.

4 out of 24 patients at the follow-up examination showed displacement of the contralateral femoral head that was greater than 3 standard deviation and was consistent with previously unrecognised physiolysis. 4 contralateral hips showed evidence of butteressing at the site of physeal reminence but the displacement was less than 3 standard deviations and so they were not considered to have slipped. 3 of these hips with buttressing had evidence of Grade I osteoarthritis. Overall incidence of bilateral SUFE in our study, excluding the 13 patients who were not available for follow-up was 25 out of 45 (55%).

This real existence of unrecognised contralateral slip, the increased risk of OA in these hips and significant rate of bilaterality, stresses the need to readdress the current mode of management of the contralateral hips in patients treated for unilateral SUFE.

Abstract: A review study of 40 skeletally immature patients with displaced, diaphyseal both-bone forearm fractures treated with open reduction, internal fixation of radius only, using Mini DCP/one third tubular plate. Forty children (age range 5–13 years), treated between 1987–1999 by one surgeon were evaluated subjectively for pain or restriction of activities at games or school, clinically for range of movements at elbow, wrist and forearm rotation, and radiologically for residual angulation and time at healing. Duration of follow up was 2–12 years. Galeazzi and Monteggia fractures, as well as fractures with metaphyseal involvement were excluded. Among 40 patients, 26 were male and 14 female. Fracture distribution was 4 (10%) upper third, 12 (30%) middle third and 24 (60%) lower third of radius and ulna. Healing time was 2–10 (mean 3.6 months). One patient went into non-union and required further surgery. One patient developed superficial cellulites around the wound, resolved by a week course of oral antibiotics. No other complications were noted. Subjective evaluation showed excellent results in all patients according to our criteria. Clinically all patients had full range of motion at elbow, wrist and forearm rotation, except two patients who were 5 degree short of pronation and one patient 10 degree short of both supination and pronation, as compared to their normal forearm. Radiologically, two patients showed residual angulation of 5 degree in ulna. We conclude that single bone fixation offers a safe and effective way of treating displaced diaphyseal fractures of both radius and ulna, with excellent functional outcome.

The goal of treatment of an intra-articular fracture is anatomic restoration of normal anatomy and rigid internal fixation to allow for early motion. Weber Type ‘B’ ankle fractures (AO Type B and Lauge-Hansen supination-external rotation) are the most common ankle fractures that require internal fixation. Brunner and Weber first described the use of antiglide plate for treatment of these fractures in 1982. The aim of our study was to assess the functional and radiological outcomes of patients who underwent this procedure. This was a retrospective analysis of a consecutive series, reviewing patients over a ten year period, from 1990 to 1999, in a regional orthopaedic and trauma unit. There were 122 antiglide plate fixations performed in total over the period under review. Our group consisted of 64 patients who had an isolated closed lateral malleolor fracture, thereby excluding patients with open injuries and bimalleolar fractures. 6 patients were lost to follow-up. There were 25 males (age 19–64 years) and 31 females (age 13–62 years) with a mean age of 42 years. The patients were assessed by the American Orthopaedic Foot and Ankle Society (AOFAS) Score and the average follow-up was 5.8 years. The implant used was a 3.5mm AO DCP applied along the posterior surface of the lateral malleolus. This was followed by early commencement of postoperative ankle and foot exercises, allowing toe touch weight bearing out of cast until union. Our results (AOFAS Score out of 100) show that 92% (52 patients) had good to excellent result (Score> 80) with only 8% (4 patients) had a satisfactory outcome. We recommend the use of an antiglide plate because of its biomechanical stability especially in osteoporotic bones which allows for early motion and the nearly nil incidence of implant removal.