A 14-year-old boy had a congenital shortening of the first right metatarsal bone, with overloading of the central metatarsals and medial deviation of the second toe. A percutaneous osteotomy and slow distraction by an external fixator for 10 weeks lengthened the bone from 32 mm to 60 mm. After the distraction, a bone graft was performed, and tenotomies and a capsulotomy corrected a threatening ...

Neglected posterior dislocation of the elbow is a common problem in developing countries. One acceptable form of treatment is open reduction and transarticular Steinmann pin fixation. However, this leads to a stable but stiff elbow. We used an improvised external fixator after open reduction in two cases, which allowed for early mobilisation with adequate stability. This option can be considere...

BACKGROUND AND PURPOSE It is not known whether there is a difference in bone healing after external fixation and after intramedullary nailing. We therefore compared fracture healing in rats after these two procedures. METHODS 40 male rats were subjected to a standardized tibial shaft osteotomy and were randomly assigned to 2 treatment groups: external fixation or intramedullary nailing. Evalu...

The modern evolutionary synthesis codified the idea that species exist as distinct entities because intrinsic reproductive barriers prevent them from merging together. Understanding the origin of species therefore requires understanding the evolution and genetics of reproductive barriers between species. In most cases, speciation is an accident that happens as different populations adapt to dif...

Open clavicle fracture is an uncommon injury mostly caused by severe direct trauma. It is often associated with multiple organ injuries. Generally, surgical intervention with debridement and fracture repair is always indicated in order to prevent infection, non-union, and malalignment. In situations of bony exposure and significant contamination concomitant with severe soft tissue damage, the e...

Distal humerus fractures are uncommon, comprising 2% of all fractures and a third of all humerus fractures. Open fractures, comminuted fractures and fracture dislocation of the elbow are often accompanied by severe soft tissue damage. External fixation of the humerus is indicated when severe soft tissue damage or the presence of infection warrants initial alternative immobilisation of the fract...