Prevention of rotatory impairment and radial head dislocation in the forearm is an important aspect when treating children with osteochondromas. Various studies tried to determine the best treatment, describing different surgical techniques. No consensus has been reached yet. This retrospective study compares the treatment outcome of patients with osteochondroma of the radius and ulna after surgical or conservative treatment. Seventeen forearms treated over a period of 20 years were analysed. Outcome parameters were the prospectively collected clinical data and the radiological findings: \"relative shortening\" of ulna/radius, the \"radial articular angle\" (RAA) and the \"carpal slip\" (CS). Our study shows an improvement of the range of motion and cosmetic appearance of the forearm after an operative procedure, with or without bone lengthening. We observed an increase in wrist and elbow mobility with a decrease in pain scores and a confirmed high cosmetic satisfaction in almost 70% of the patients after bone lengthening and up to 85% after simple excision. For patients suffering from functional impairment or pain, an operative approach is beneficial. Multiple and repetitive osteochondroma excisions are recommended during growth to prevent deformity and rotatory motion restriction. Lengthening procedures require a careful indication.

Congenital radial longitudinal dysplasia remains an \'unsolved problem\' in hand surgery. The challenges presented by the skeletal deficiency of the distal radius and soft tissue dysplasia of the severe radial longitudinal deficiency have been addressed by a number of techniques that aim to stabilize the position of the hand relative to the forearm and optimize forearm growth and hand function. Analysis of hand function and position in these children is difficult because of the abnormal \'wrist\' mechanics, and the published results of the techniques used to date often lack a standardized approach and importantly the perception of function from the patient\'s perspective. The existing data is reviewed and compared with the results of cohorts from two major congenital upper limb centres. Soft tissue distraction prior to radialization or centralization may offer benefit in ulnar growth and forearm length but there is a need for further research into the long-term functional outcomes of the various techniques available to determine the optimal choice for these children.Level of evidence: V.

Background and aim Contact burn injuries to the hand are common in the paediatric population, with the most common aetiology involving touching hot surfaces in the household. The hand is also often involved in paediatric scald injuries. The aim of this study was to determine the different presentations of hand burn injuries and analyse the outcomes in the paediatric population at Royal Aberdeen Children\'s Hospital (RACH). Methods Anonymised clinic data for paediatric patients with hand burns presenting to our burn centre from 2017 to 2020 were retrospectively reviewed. A total of 52 patients (65 affected hands) were included in the study. Clinic letters stored on NHS Grampian\'s electronic patient record system were reviewed for burn surface area, time to healing, management measures including medications prescribed and sequelae of the burn injury. Results The average patient age was three years and four months old. There were 31 male patients and 21 female patients. Paediatric hand burns were most commonly confined to the palm only, followed by the fingers only. Contact with a hob was the most common aetiology, followed by scald burns. The average time to healing was 10 days (range 2-28 days). No correlation was found between length of stay on initial hospital admission and time to complete healing. A total of 86.5% (n=45) of patients were managed with dressings and 13.5% (n=7) of patients underwent surgical management. Of these seven patients, four had surgical debridement of burn tissue, washout, and dressing, and the remaining three had an excision and grafting with thick split-thickness skin grafts. Of these three patients, one patient had to undergo secondary reconstruction with a full-thickness skin graft. Conclusion It has been found that most patients in this study completely healed with primarily conservative measures of dressing care and regular check-ups. Isolated hand burns in the paediatric population present a low rate of sequelae and palms are the most common area of burn injury in this demographic.