We followed prospectively 295 patients with trochanteric fractures treated with the proximal femoral nail. The average age of the patients was 80 years and three out of four were female. The most frequent fracture type was A2 (59%). Clinical and radiographic controls were performed at 1, 3 and 6 months. There were technical complications during the operation in 12% of the cases, complications in the immediate postoperative period in 27% and late complications were detected in 4% of patients. Previous walking ability was recovered by 71%. The surgical technique is not complex, the number of complications recorded was acceptable and the overall results obtained are comparable with other fracture systems.Résumé Nous avons suivi 295 patients avec des fractures trochantérienne traitées avec un Clou Fémoral Proximal. L'âge moyen était 80 ans et 3/4 des patients étaient des femmes. Les fractures ont été classifiées avec le système AO, la plus courante étant du type A2 ( 59%). Des contrôles cliniques et radiologiques ont été effectués 1, 3 et 6 mois après l'intervention. On a enregistré des complications techniques pendant l´opération dans 12% des cas, des complications postopératoires précoces dans 27% et des complications tardives dans 4% des cas. 71% des patients ont récupéré la déambulation précédente. La technique opératoire n'est pas difficile, le nombre des complications est acceptable et les résultats globaux obtenus sont comparables á ceux obtenus avec d'autres matériels pour le traitement de ce type de fractures.

The present study demonstrates for the first time the anti-resorptive efficacy of alendronate given immediately after surgical repair in an elderly population with recent hip fracture. This effect should positively affect the rate of subsequent fractures.

Radioulnar synostosis and intra-articular extension of the injury are poor prognosis factor in floating elbow.

Objective: Carpal tunnel syndrome (CTS) is the most common focal nerve injury. People with CTS may show alterations in central processing of nociceptive information. It remains unclear whether the central sensitization inventory (CSI) is capable of detecting such altered central pain processing. Methods: Thirty healthy volunteers were matched with 30 people with unilateral CTS from the orthopaedic waitlist. Changes to central pain processing were established through psychophysical sensory testing (bilateral pressure pain thresholds (PPT), conditioned pain modulation, temporal summation) and pain distribution on body charts. Patients also completed pain severity and function questionnaires, psychological questionnaires and the CSI. Results: Compared to healthy volunteers, patients with CTS have lower PPTs over the carpal tunnel bilaterally (t = −4.06, p < 0.0001 ipsilateral and t = −4.58, p < 0.0001 contralateral) and reduced conditioned pain modulation efficacy (t = −7.31, p <0.0001) but no differences in temporal summation (t = 0.52, p = 0.60). The CSI was not associated with psychophysical measures or pain distributions indicative of altered central pain processing. However, there was a correlation of the CSI with the Beck Depression Inventory (r = 0.426; p = 0.019). Conclusion: Patients with CTS show signs of altered central pain mechanisms. The CSI seems unsuitable to detect changes in central pain processing but is rather associated with psychological factors in people with focal nerve injuries.

The use of quadrangular plates for arthrodesis of the trapeziometacarpal joint is a safety and reproducible technique with a low rate of complications. Arthrodesis decreases pain and improves function in patients with primary osteoarthritis of the thumb carpometacarpal joint; in spite of a mild loss of motion, patients are satisfied with this procedure.