Introduction: High tibial osteotomy is an established procedure for the mid-term treatment of unicompartmental osteoarthritis of the knee, especially in young patients. Nevertheless, its performance at the proximal end of the tibia, close to the site of insertion of the extensor mechanism of the knee, might produce anatomic alterations of the latter, which, in turn, could influence the final result.

Aim: The purpose of the present retrospective study is the radiologic evaluation of the anatomic changes of the extensor mechanism of the knee, caused by high tibial valgus osteotomy (closed-wedge step osteotomy, with internal fixation).

Material – Method: For this purpose we studied the X-rays of 44 kness (pre-op, p-op and 1 year p-op) that had undergone the above procedure. The assessed variables were the horizontal and vertical shift of tibial tubercle as well as the position of the patella (patellar vertical height, Linclau, Caton).

Results: We didn’t find any statistically significant difference of the postoperative position of the patella with respect to the preoperative one (p=0.88), whereas there was definite proximal and anterior shift of the tibial tubercle in a statistically significant degree (p< 0.01) with respect to the preoperative situation.

Conclusions: The certain type of high tibial osteotomy seems to impart an unloading effect on the patellofemoral joint (due to the anterior shift of the tibial tubercle). On the contrary, the vertical shift of the tibial tubercle seems to have no effect to the postoperative position of the patella.

Purpose: The aim of this study is the evaluation of the use of plate and screws without restoration of the opposite cortex and without the use of bone graft in the treatment of multifragmentary fractures of femur.

Material and Methods: For this purpose, we retrospectively studied 26 multifragmentary femoral fractures that were treated in our department in accordance with the above principles, between 1992 and 2001. All fractures were reduced indirectly with traction on the fracture table without any direct manipulation at the comminution zone. Emphasis was given to the restoration of the proper length, axial and rotational alignment of each fracture. The fixation was done with a long bridge plate, without the use of interfragmentary screws.

Twenty five of the fractures (96.5%) united, without any serious complication, within 3–5 months. In one fracture the fixation failed and had to be revised.

Conclusions: The use of plate and screws in the treatment of multifragmentary fractures of femur, once it is done with complete respect to the fracture biology leads to speedy fracture union, high union rate and a very low complication rate.