The purpose of this retrospective study was to report the results using scarf, first metatarsal osteotomies, in correcting Hallux Valgus deformity with H-V angle > 35°.

During the period 2003–2008 we did 23 scarf, first metatarsal osteotomies in 15 patients (8 bilateral).In order to evaluate the effectiveness of this operation, patients were clinically (aofas score) and radiologically (X –ray in 4, 8, 12 weeks) assessed.

Mean follow up was 32 months. The results evaluated with the aofas score in order to study the function, the pain and the overall satisfaction of the patients. We had excellent results in 13 %, very good in 48 % good 32% and poor 7 %.There was only one complication and no one infection.

According the above results it seems that scarf osteotomy is quite reliable surgical treatment of severe Hallux – Valgus deformity with an increased IM angle.

Objective: To evaluate retrospectivelly the outcome of periarticular tibial pilon fractures treated by hybrid external fixation.

Method: Between 1999–2003, 44 patients(44 fractures) were treated with a combination of hybrid external fixation and minimal internal fixation(k-wires or lag-screws). There were 31 men and 13 women with a mean age of 41 years. A high energy trauma( accident or fall from a height) was the mechanism of injury for 32(73%) patients. According with A.O. clasiffication 4 fractures were A1, 5-A2, 5-A3, 8-C1, 12-C2,10-C3. All fractures were treated within a 10 days from the initial injury (10(23%) of them were open and treated immediately). The use of bone grafts reguired in 8 cases. Primary postop mobilization of adjacent joints was performed in all cases. Fourty patients were available for clinical and radiographic evaluation(using Teeny’s and Wiss ancle score). The average follow-up was 26 months.

Results: There were 9(23%) excellent, 12(30%) good, 10(25%) fair, and 9(23%) poor results. Union achieved in 40(92%) cases. Overall, 12(30%) complications reported: 6 pin track infections, 2 deep infections, 4 non-unions and 1 malunion. Post-traumatic osteoarthritis noticed in 11(28%) cases.

Conclusions: Hybrid external fixation permits early mobilization of the ankle joint and decrease the soft tissue trauma. Poor results associated with the presence of infection, the degree of intraarticular involvement and the inability to achieve adeguate fracture reduction.

Aim: Complex tibial plateau fractures, Shatzker type VI, rare in the past, became more common nowadays because of high energy injuries. These complex fractures usually accompanied by compromised skin and soft tissue envelope requires deliberate planning as treatment in the past invite a high rate of complications.

Materials and method: During a period of 24 months, 16 fractures of tibial plateau, Shatzker VI, were treated in 16 patients, all regarding vehicle accidents.11 patients were men and 5 women with a mean age of 42 years old (27–67).There were 2 open and 14 closed fractures (3 type I, 8 type II and 3 type III according to Tscherne’s classification).All cases were treated with circular external fixators (hybrid), whereas 9 of them needed additional mini internal fixation (one or two screws).

Results: 14 patients were evaluated with a mean period of follow up 1.9 years. Healing was achieved in all 14 cases with a mean period of 16 weeks (12–24).Fixator removal was performed when bone healing was completed. There was no deep infection. 12 patients at the end of treatment had a range of motion between 0° – 120°. 3 fractures developed a malunion (1 valgus deformity, 2 anterior angular deformity). Radiographic evidence of arthritis appeared in 2 patients during follow up. Pin tract infection occurred in one case, treated with antibiotics.

Conclusion: The use of circular external fixators (three olive wires to tibial plateau) obtains good stabilization while allows early joint motion, protects soft tissue envelope and in combination with minimal internal fixation achieves satisfactory reduction of comminuted fractures making the technique promising for the management of these complex fractures.