Purpose: The supracondylar fractures of the distal humerus are the second most frequent fractures of the developing skeleton. Also their immediate and late complications are very often. The aim of this study is to describe their neurological complications.

Material – methods: In our department 178 children were admitted with supracondylar fracture of the distal humerus during the period 1998–2002. Their age ranged from 2 to 16 years of age (the average was 7 years old, 63 girls and 115 boys). Forty-six patients were treated conservatively and 132 surgically. Neurological complications were appeared in 18 patients that had, according to Gartland classification, II and III type fractures. Manipulations for closed reduction had been made to 6 of them. Neurological deficit of the median nerve appeared to 10 patients, of the radial nerve to 6 patients and of ulnar nerve to 2 patients. The treatment of the fractures was surgical (open reduction, internal fixation with Kirschner wires and immobilization with a long arm cast for 4 weeks). The treatment of the neurological complications was conservative (free mobilization of the elbow was followed after the removal of the arm cast and Kirschner’s wires).

Results: The results of the conservative treatment of the neurological complications of the supracondylar fractures of the distal humerus were excellent and the surgical exploration on the injured nerve was not necessary on any patient. The function of the nerves recovered completely in 2–3 months after the elbow’s fracture.

Conclusion: The prognosis on the neurological complications of the upper limbs due to supracondylar fracture of the distal humerus is very good. They are successfully treated conservatively and the surgical exploration on the injured nerve is rarely necessary.

The aim of this paper is to present our experience from the surgical treatment of lower limb fractures in the developing skeleton with the use of bio-absorbable PLLA implants as a means of internal fixation.

From 1997 until 2002, twenty-three patients (15 boys and 8 girls, ages ranging from 7 to 15 years old, mean of 12 years) who had suffered from 30 lower limb fractures were operated on in our department, with the use of PLLA screws as a means of internal fixation that followed the standard open reduction procedure.

We surgically treated 20 tibial fractures (distal metaphysis:1,medial malleolar:6,distal epiphysis lesions:9,tibial spine:2, lateral tibial condyle:1, tibial shaft:1), 8 fibular fractures (distal metaphysis:2, distal epiphysis lesions:5, fibular shaft:1), one transtrochanteric fracture and 1 patellar fracture.

All patients were operated on under constant radiographic control. A cast was applied, post-operatively, to all patients, for a period of 3–4 weeks. Gradual and assisted weight-bearing and ambulation, was commencing immediately after the cast removal.

All patient’s (with the exception of 1 case of delayed callus formation) post-operative period was completely normal. However, follow-up revealed the development of osteolytic lesions (bone absorption cysts) in 3 of our patients. All lesions were located in the border between epiphysis and metaphysis, at the exact position were the PLLA screws had been placed.

The use of PLLA implants in the treatment of fractures renders unnecessary a second operation for the removal of the osteosynthesis’ material. Nevertheless, we should be quite reluctant when deciding to use the PLLA screws in the treatment of these fractures in the developing skeleton, especially of the lower limbs, were the applied weight bearing forces are quite powerful.