The TSP may be an aid in the treatment of these difficult fractures because the problem with femoral shaft fractures using the Gamma nail is avoided and the medialization of the distal fracture fragment frequently associated with the CHS is prevented.

There is no evidence of a difference in functional outcome at 1-year follow-up between surgical treatment and conservative treatment of displaced proximal humeral fractures in elderly patients.

No abstract

The influence of perioperative soft tissue complications on the functional outcome after open reduction and internal fixation of closed ankle fractures was investigated. Eighty-eight consecutive patients were followed 3.7 years (SD +/- 0.6) after the injury. Two major and 21 minor soft tissue complications were registered. Average dorsal extension was 29.9 degrees (range four to 54, SD +/- 9.5) of the fractured ankles and 37.2 degrees (range eight to 60, SD +/- 9.1) of the non-fractured ankles. The average subjective functional score was 84.6 (range 40 to 100, SD +/- 14.9). A significant difference was found with respect to the subjective functional score (p = 0.048, Kruskal-Wallis test) but not with respect to dorsal extension (0.358, Kruskal-Wallis test) when comparing groups of minor, major and no soft tissue complications. This study suggests that major soft tissue complications have a negative effect on the long-term functional outcome after surgical repair of an ankle fracture. Minor soft tissue complications, primary skin problems, the timing of primary surgery and fracture types according to AO/ASIF have no or minor influence on the long-term functional result. This study confirms previous reports that the presence of osteoarthritis is frequently associated with a reduced functional outcome.

No abstract

We randomised 50 patients with ankle fractures of Weber types B and C and a ruptured deltoid ligament treated by open reduction and internal fixation to two treatment groups to examine the influence of the repair of a ruptured deltoid ligament. No differences were found except for a longer duration of surgery in the repair group. Our findings suggest that a ruptured deltoid ligament can be left unexplored without any effect either on early mobilisation or on the long-term result.

We analysed the results of 93 tibial shaft fractures treated with the Grosse-Kempf locked nail. Twenty-six fractures were comminuted, 19 were open grade I to II, and 54 were located outside the middle third of the tibia. The deep infection rate was 3.2%. There were only two poor results. The use of this method is recommended and discussed.

No abstract