Osteosynthesis of fresh humeral shaft fractures, indications and results

Seventeen patients with humeral shaft fractures were operated upon by open reduction and internal fixation using the standard A.O. plating techniques. The indications for open reduction and internal fixation [ORIF] had been discussed. The approach for plating technique in different level of humeral shaft fracture had been described. Narrow D. C.P. was mostly used which was combined with bone grafting whenever needed. The patients followed up until fracture union. The overall result was excellent in 10 patients, good in 4, fair in 2, and poor in one patient who had an associated brachial artery injury. There was no delayed or nonunion, however, there was one case of deep infection which passed uneventual

Iliotibial band reconstruction for anteromedial knee instability

Sixty two patients of anteromedial instability were treated by using the illiotibial band as a reconstructive procedure of combined extra-articular and intra-articular technique with medial capsulo-ligamentous repair. The age of the patients ranged from 18 to 40 years [average 28 y.]. 55 patients were injuried during sports and 7 in road traffic accidents. The average time between operation and accident was 2.5 years. The aneromedial instability was diagnosed by anterior drawer sign, Lachman test and pivot-shift sign and evaluated using the anterior drawer test with external rotation of 30 degrees to measure both anterior and medial instability [1 + in 7, 2+ in 10, 3+ in 20 and 4+ in 25]. They were followed up for thirty months. Results were graded according to Kennedy et al [1974], it was excellent in 14 patients [22.5%]. Good in 33 patients [53.22%], fair results in 18 patients [12.9%] and poor results in 7 cases [11.29%]. Complications occurred in 5 cases, 2 patients with vastus lateralis herniation, 2 patients developed knee stiffness and one case developed wound haematoma in the thigh region with superficial infection. The illiotibial band reconstruction with medial capsulo-ligamentous repair was satisfactory and simple repair for anteromedial instability of the knee. The indication for surgery should be limited to the unpredictable episodes of instability that occur frequently during the course of everyday activity and do not improve with rehabilitation exercises