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1/4. Opening-wedge osteotomy, allografting with dual buttress plate fixation for severe genu recurvatum caused by partial growth arrest of the proximal tibial physis: a case report.

    Injuries to the proximal tibial physis are among the least common epiphyseal injuries. We present a case of severe genu recurvatum deformity (45 degrees) with leg length discrepancy (4 cm) following a neglected proximal tibial physeal injury incurred 6 years previously. The 16-year-old patient was successfully treated by open-wedge osteotomy, allograft reconstruction, and dual buttress plate fixation. At 3 years' follow-up, the patient was asymptomatic, fully active with a full range of motion (0 - 140 degrees) of the leg, and equal leg lengths. There were no signs of genu recurvatum clinically.
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2/4. Microsurgical fibular graft for full-length radius reconstruction after giant-cell tumor resection: a case report.

    In this article, we present the treatment of a recurrent giant-cell tumor of the radius with en bloc resection and full-length radius reconstruction with a 24-cm long microsurgical fibular graft. At time of 8-year follow-up, there was no evidence of tumor recurrence. A satisfactory range of motion of the elbow, wrist, and forearm was maintained. There was no instability in the joints, and grip strength measured 63% of the opposite side. With appropriate dynamic tendon transfer, this procedure can provide an alternative method for reconstruction of the full-length radius after tumor resection, with functional and durable results.
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3/4. humerus varus in a patient with pseudohypoparathyroidism.

    A 7-yr-old girl presented with progressive shortening of the right upper arm and limitation of shoulder motion. pseudohypoparathyroidism associated with Albright's hereditary osteodystrophy was diagnosed by biochemical, hormonal and radiographic studies. Her condition was complicated by severe humerus varus on the right side. Proximal humeral valgization osteotomy and concomitant humeral lengthening resulted in an improvement of the shoulder joint motion and activity in daily life.
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4/4. Premature closure of the distal radial physis after fracture of the distal radial metaphysis.

    Two fractures of the distal radius seemingly with lack of involvement of the distal radial physis are presented. Nevertheless, complete arrest of the adjacent physis occurred, suggesting a Salter-Harris V mechanism of injury to the vulnerable distal radial physis. Ulnar "overgrowth" produced impingement of the carpus and functional complaints sufficient to warrant treatment. In this clinical setting, an ulnar-shortening osteotomy done at skeletal maturity resulted in marked improvement in the range of motion at the radiocarpal joint and corresponding improvement in function for both patients so treated.
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