Background: Intramedullary elastic rod fixation of midshaft clavicular fracture results in rapid free movement of the shoulder and an earlier return to daily activities than the conservative treatment. In comparison with plate fixation, the procedure is less invasive, with no loss of fracture haematoma, rapid union, and less infection. No major surgery for removal with less injury to surrounded neurovascular structures. A smaller incision is required with superior cosmesis. Objective: To study the short-term results of treatment of displaced fractures of the middle third of the clavicle using percutaneous elastic intramedullary nails Patient and Methods: This prospective study was carried out on twenty patients with displaced fractures of the middle third of the clavicle presented to the Hospital and treated by percutaneous elastic intramedullary rod between November 2019 and May 2020. Results: At the end of the follow-up period, the mean score was 89.70 ± 13.55 ranging from 48 to 100 according to the modified Constant and Murley shoulder score. Fourteen patients (70%) had excellent results, four patients (20%) had good results, one patient (5%) had a fair result, and one patient (5%) had a poor result. Conclusion: Elastic stable intramedullary nailing (ESIN) is an image dependant procedure indicated best for young medically free patients with acute simple 2 part middle third clavicle fracture. Delay in surgery may necessitate open reduction. Hammering is not recommended to avoid dorsolateral cortex perforation.
Background. Fractured stem of the hip prosthesis is well documented in the literature. Although it is rare, it is considered as a challenging problem. Many techniques have been described to solve this problem. Purpose of the Study. Evaluation of the effect of anterolateral bone window for extraction of the cemented femoral stem of hemiarthroplasty in revision total hip replacement. Methods. The study included eight revision hip arthroplasties in eight patients, with a broken stem of cemented (Thompson) hemiarthroplasty, which has been revised by the anterolateral proximal femoral window. All cases received cemented cups and cement-in-cement stems, except one case who received cementless long stem. Clinical follow-up of cases by Harries hip score (HHS) and X-ray. Results. Functional improvement of HHS of all cases, with no signs of loosening, after a mean follow-up period of 1.5 years. Conclusion. Extraction of broken stem is a challenging procedure. Many techniques have been described for revision of cases with a fractured stem of hip prosthesis, but we think that the anterolateral femoral bone window is a reproducible technique due to the characteristics of simplicity, short-time procedure, less invasive, not requiring extra instruments, and can be successful for most patients.
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