Antegrade intramedullary interlocking nailing versus plating for the treatment of humeral shaft fractures

This prospective r and omized study included 46 humeral shaft fractures managed by antegrade intramedullary interlocking nail [Group I] and compression plate [Group II] with 23 patients in each group. The mean age was 35.6 years in group I and 33.8 years in group II [p>0.05]. The mean blood loss was 145 ml in group I while it was 437 ml in group II [p<0.05]. The mean operative time was 66.7 minutes for group I and 88.2 minutes for group II [p<0.05]. the average time of union was 14.9 weeks for group I and 15.2 weeks for group II [p>0.05]. The UCLA shoulder rating scale was used for assessment of the shoulder function. In group I four patients had excellent results, 13 patients had good results and six patients had fair results, while in group II, 18 patients had excellent results and five patients had good results. The modified rating system of Morrey et al. was used for assessment of the elbow function. All patients in group I had excellent results while in group II 17 patients had excellent results and seven patients had good results

Fractures of the neck of the talus

Eleven fractures of the talus in 11 patients were treated and followed up. The mechanism of injury was dorsiflexion in 64%, planter flexion in 18%, eversion in 9% and unknown during car accident in 9%. According to Hawkins, the cases were classified into three groups: group 1 [2 cases], group 2 [5 cases], group 3 [4 cases]. The degree of displacement was directly proportional to the severity of injury, the displacement at the fracture site was usually associated with subluxation or dislocation of the posterior part of the subtalar joint. The results of cases with dislocation of the subtalar joint were better after open reduction and internal fixation. In cases of complete talar dislocation in spite of the major damage to the blood supply of the taller body at the time of injury good functional results can be achieved with early accurate reduction stable rigid fixation of the taller neck