Background: The details regarding bone formation and complication rates associated with tibial lengthening over an intramedullary nail with use of the Ilizarov external fixator have not been reported, to our knowledge. The purpose of this study was to review our experiences with this procedure, performed in individuals with idiopathic short stature. In addition, we compared the results of lengthening over a nail, in terms of the observed bone formation and the complications, with those of the conventional Ilizarov method. Methods: Eighty-eight tibiae in forty-four individuals with a mean preoperative height (and standard deviation) of 153.7 ± 7.2 cm were included in the study. Thirty-two tibial lengthening procedures were performed with the conventional method and fifty-six, with a nail. The increase in the length of the tibia, the external fixation index, the healing index, and complications were assessed. Three specific concerns, including mobility during the lengthening procedure, the time interval before the patient could return to previous activities after completion of the lengthening, and physical activities at the time of final follow-up, were also assessed. Results: The mean final height was 160.1 ± 7.0 cm, and the mean gain in tibial length was 6.2 cm (20.0%). There was no difference in the mean gain in tibial length or the healing index between the groups; however, the external fixation index was lower and there were fewer complications per tibia in the group treated with the lengthening over a nail. The individuals treated with lengthening over a nail coped better with outdoor activities during the treatment period than the individuals treated with the conventional Ilizarov method; however, there was no difference in the time until the individual returned to previous activities or in the ability to carry out physical activities at the time of final follow-up between the groups. Conclusions: Tibial lengthening with use of the Ilizarov external fixator over an intramedullary nail results in new bone formation of a quality equal to that obtained with the conventional Ilizarov method; however, it reduces the duration of external fixation and the rate of complications. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

Displaced medial humeral epicondyle fractures with or without elbow dislocation have been treated with open reduction and fixation using K-wires or screws. The purpose of this study is to evaluate the clinical and radiological outcomes of surgical treatments of medial humeral epicondyle fracture without elbow dislocation according to the fixation methods. Thirty-one patients who had undergone open reduction and fixation of the displaced medial humeral epicondyle fracture without elbow dislocation were included. Group I consisted of 21 patients who underwent fixation with K-wires, and Group II comprised 10 patients who underwent fixation with cannulated screws. Immediate postoperative, final follow- up and normal anteroposterior radiographs were compared and the clinical outcome was assessed using the final Japanese Orthopaedic Association (JOA) elbow assessment score. On the immediate postoperative radiographs, the distal humeral width in Group II was larger than that in Group I. On the final follow-up radiographs, the epicondylar position in Group I was lower than that in Group II. There was no significant difference in the distal humeral width, epicondylar position and joint space tilt between the immediate postoperative, final follow-up radiographs and the normal side within each group. There was no significant difference in the final JOA score between groups. Open reduction followed by K-wire fixation or screw fixation of the displaced medial humeral epicondyle fracture without elbow dislocation in older children and adolescents resulted in improved radiologic outcome and good elbow function in spite of diverse radiologic deformities.