Our experience in the treatment of 50 scaphoid nonunions treated with Herbert screw fixation is reviewed. Success rates fell off as the duration of nonunion before treatment increased. However, this appeared to be related to the increased incidence of avascular necrosis with time rather than simply the factor of time alone. In this series the major adverse determinants for outcome were avascular necrosis and a history of previous surgery for nonunion. Failure to graft in a selected group with an intact cartilaginous envelope or a stable firm fibrous union did not affect results. The heterogeneous nature of any series of scaphoid nonunions is emphasized and the difficulties in comparing results with cohorts unmatched for the various adverse factors discussed is stressed.

Objectives: To assess the functional outcome in supracondylar femur fracturesfixed with intramedullary tibial nail. Study Design: Prospective case series. Setting: Al Noorspecialist hospital, Makkah, Saudi Arabia. Period: Four years (2009-2013). Methods: 25patients with closed supracondylar femoral fractures operated with tibial intramedullary nail. Thefunctional outcome was measured by Tegner Lysholm criteria during and after 4 years. Results:Out of 25 patients 20 were male and 5 were female. The mean time of healing was 15.80(2.646)weeks. 6(24%) patients showed excellent results, 12(48%) patients showed good results and7(28%) patients showed fair results. There were no poor results in our study. Conclusions:Retrograde tibial nails are cheaper, convenient and lead to good functional outcome in patientswith supracondylar femur fractures.

Four years (2009Four years ( -2013. Methods: 25 patients with closed supracondylar femoral fractures operated with tibial intramedullary nail. The functional outcome was measured by Tegner Lysholm criteria during and after 4 years. Results: Out of 25 patients 20 were male and 5 were female. The mean time of healing was 15.80(2.646) weeks. 6(24%) patients showed excellent results, 12(48%) patients showed good results and 7(28%) patients showed fair results. There were no poor results in our study. Conclusions: Retrograde tibial nails are cheaper, convenient and lead to good functional outcome in patients with supracondylar femur fractures.