Between 1997 and 2001 we treated 54 elderly patients with unstable intertrochanteric fractures by primary hemiarthroplasty using a cemented bipolar prosthesis. Mean patient age was 75.6 (64-91) years and mean follow-up was 22.3 (5-48) months. Seven patients died before the fourth post-operative month. Thirty-three patients were able to walk with a walker in the first postoperative week. There were no dislocations or aseptic loosening. One deep infection was encountered after 1 year. Acetabular erosion was seen in one patient and non-union of the greater trochanter was seen in four. Five patients experienced leg-length discrepancy. We obtained 17 excellent and 14 good results after 12 months according to the Harris hip-scoring system. We observed that the inner motion of the bipolar head decreased over time.Résumé Entre 1997 et 2001 nous avons traité 54 malades âgés avec fracture intertrochanterienne instable par hémiarthroplastie utilisant une prothèse bipolaire cimentée. L'âge moyen des malades était 75.6 (64-91) années et le suivi moyen étaient 22.3 (5-48) mois. Sept malades sont morts avant le 4e mois post-opératoire. 33 malades étaient capables de marcher avec un déambulateur pendant la première semaine post-opératoire. Il n'y avait pas de luxation ni de descellement aseptique. Une infection profonde s'est manifestée après une année.Une érosion acétabulaire a été notée chez un patient et une non -consolidation du grand trochanter chez quatre patients. Cinq malades avaient une inégalité de longueur des membres inférieurs. Nous avons obtenu 17 excellents et 14 bons résultats après 12 mois d'après le score de Harris. Nous avons observé que le mouvement intérieur de la tête bipolaire a diminué avec le temps.

Isolated fractures of the capitellum are rare injuries and account for 1% of all elbow injuries. The purpose of this study is to evaluate the clinical outcomes of 11 Type I capitellum fractures treated by open reduction and internal fixation using at least two standard Herbert screws between 1998 and 2003. The average age of the patients was 27.5 years. The mean follow-up time was 23.4 months. The final postoperative assessment was made at the 12th month. The results were evaluated according to the Mayo Elbow Performance Index. We obtained excellent result in eight patients and good result in three patients. We recommend open reduction and fixation with Herbert screws inserted from the posterior surface of the lateral epicondyle and early mobilization in Type I fractures of the capitellum.

We reviewed 14 patients with chronic lateral instability of the ankle treated by Colville's technique between 1996 and 2001. The mean patient age was 25 (20-35) years and all were men. The mean period between injury and surgery was 25 (18-32) months, and the mean follow-up was 20 (14-32) months. Twelve of the results were excellent and two were good according to the criteria of Chrisman and Snook. All patients returned to normal daily activity levels at an average of 6 months following surgery. Résumé

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A series of eight cases is presented in which similar fractures of the shaft of the humerus occurred during the throwing of hand grenades. Transient paresis of the radial nerve accompanied the fracture in one patient. In seven patients, the fracture healed without complication. In the remaining case, non-union developed, and surgical treatment was instituted. The mechanism of the fracture is discussed with reference to the literature.

We reviewed 12 male patients with scaphoid nonunions treated by open reduction, bone grafting, and internal fixation with biodegradable implants made of selfreinforced poly-L-lactic acid. Mean patient age was 22.5 (20-25) years. Ten patients had type D2 scaphoid nonunions with a fracture line in the middle one third, one patient had type D2 nonunion with a fracture line in the proximal one third, and one patient had type D1 distal one-third fibrous union. The mean wrist score (modified Mayo wrist score) was 20.8 (10-40) preoperatively and improved after 22-80 months (55-90). All nonunions healed, and the mean solid union time was 4.5 (3.5-7) months. We obtained excellent results in five patients, good results in four, fair results in two, and a poor result in one. The results of this study offer a valid alternative in the fixation of scaphoid nonunions. The major advantage of biodegradable materials is to eliminate the requirement for the removal of the fixation material.Résumé Nous avons examiné douze malades de sexe masculin avec une non-consolidation du scaphoïde traitée par réduction ouverte, greffe osseuse et fixation interne avec des implants biodégradables faits d'acide poly-Llactique auto-renforcé (SR-PLLA). L'âge moyen des malades était de 22.5 ans (20)(21)(22)(23)(24)(25). Dix malades avaient une non-consolidation de type D2 avec le trait de fracture dans le tiers central, un malade avait le type D2 avec un trait de fracture dans le tiers proximal et un malade avait le type distal D1 avec union fibreuse. Le score moyen du poignet (Mayo wrist score modifié) était 20.8 (10-40) en préopératoire et amélioré après 22 mois à 80 (55-90). Toutes les nonunions ont consolidées dans un temps moyen de 4.5 mois (3.5-7). Nous avons obtenu d'excellents résultats chez cinq malades, de bons résultats chez quatre, des résultats médiocres chez deux et un résultat mauvais pour une. Les résultats de cette étude offrent une alternative valide pour la fixation des non-consolidations du scaphoïde. L'avantage majeur des matières biodégrad-ables est d'éliminer l'exigence d'ablation du matériel d'ostéosynthèse.

Therapeutic IV.