Superior dislocation hip with anterior column acetabular fracture - open reduction and internal fixation using a twin incision technique

Superior variety of anterior dislocation of the hip is a rare injury. Its occurrence with acetabular fractures has been documented infrequently. We report a case of superior dislocation of the hip with anterior column acetabular fracture. Open reduction of the hip and internal fixation of the fracture was carried out using a twin incision technique. The course to recovery has been uneventful.Pan African Medical Journal 2012; 12:4

Hoffa fracture: analysis of factors affecting the final outcome after treatment with partially threaded screws

Background: Coronal fractures of the femoral condyles are rare injuries.Methods: This retrospective case series included patients with coronal fractures of the femoral condyles managed operatively. The surgeries were performed by authors NJ, RL and VB. A total of 11 patients with Hoffa fracture were operated between May 2011 and July 2012.Results: We report the outcome of open reduction and internal fixation using partially threaded screws in 11 patients with Hoffa fracture. There were 10 male and 1 female patient operated at a mean age of 37 years. The average duration of follow up was 15.6 months. Fractures in all the patients united with a mean 115.450 range of flexion at knee at final review. The final outcome had a poor correlation with the shear angle of the fracture but fracture comminution and open nature of injury had a negative effect on the final outcome achieved. The number of screws used and the type of rehabilitation followed post operatively also had no bearing on the final range of motion achieved.Conclusions: Partially threaded screws offer consistently good results in coronal fractures of the femoral condyles and the outcome is dictated only by perioperative factors like comminution and open nature of injury

Nonunion of paediatric talar neck fracture

【Abstract】Fractures of the paediatric talus are infrequent injuries, most complicated by posttraumatic arthrosis and avascular necrosis in the course of treatment. Non- union in children has not been reported before in literature. We report a case of a 12-year-old boy who had a nonunion of Hawkins type II fracture of talar neck. The nonunion was treated surgically with a good clinical outcome. The goals of management in nonunion of paediatric talar neck fracture are different from those in fresh fractures. A suboptimal reduction should be acceptable without trying a radical surgery which may cause further impairment

Flexible intramedullary nailing in paediatric femoral fractures. A report of 73 cases

Abstract Background Flexible intramedullary nailing has emerged as an accepted procedure for paediatric femoral fractures. Present indications include all patients with femoral shaft fractures and open physis. Despite its excellent reported results, orthopaedic surgeons remain divided in opinion regarding its usefulness and the best material used for nails. We thus undertook a retrospective study of paediatric femoral fractures treated with titanium or stainless steel flexible nails at our institute with a minimum of 5 years follow up. Material and methods We included 73 femoral shaft fractures in 69 patients treated with retrograde flexible intramedullary nailing with a minimum follow up of 5 years. Final limb length discrepancy and any angular or rotational deformities were determined. Results Mean age at final follow up was 15.5 years (10-21 years). Mean follow up was 7.16 years (5.0-8.6 years). Titanium and stainless steel nails were used in 43 and 30 cases respectively. There were 51 midshaft, 17 proximal, and 5 distal fractures. All fractures united at an average of 11 weeks but asymptomatic malalignment and LLD were seen in 19% and 58% fractures respectively. LLD ranged from -3 cm to 1.5 cm. Other complications included superficial infection(2), proximal migration of nail(3), irritation at nail insertion site(5) and penetration of femoral neck with nail tip(1). There were 59 excellent, 10 satisfactory and 4 poor results. Conclusion Flexible intramedullary nailing is reliable and safe for treating paediatric femoral shaft fractures. It is relatively free of serious complications despite asymptomatic malalignment and LLD in significant percentage of fractures.</p