Primary unreamed and unlocked intramedullary nailing for open tibial fractures

Objective: The purpose of this study is to present our experience with the use of primary unreamed and unlocked nailing by the curved Kuntscher nail for open tibial fractures.Design: A retrospective study carried out between 1993 and 2003.Setting: Department of Orthopaedics Surgery; Yopougon Teaching Hospital; Abidjan; Coted'Ivoire.Patients and methods: A total of 154 open tibial shaft fractures in 149 patients were operated on by primary stabilisation with an unreamed and unlocked Kuntscher nail. Postoperatively; patients wore a leg plaster cast. Results: There were 124 men and 25 women with a mean age of 35 (16 to 72) years. Fractures werecaused in the majority of cases (130 cases; 87.2) by traffic accidents. Fractures were classified according to Cauchoix system into 96 grade I; 55 grade II; and 3 grade III. The duration of follow-up averaged nine (3 to 25) months. Infections (softtissue and bone) were encountered in 30 (19.5 ) fractures. 113 fractures (86.25 ) were primarily united with an average of 4.7 (two to six) months.Bone union was delayed for seven (5.3 ) fractures. Eleven (8.45 ) fractures developed nonunion. Malunion in valgus 10o was seen in three patients and in varus 10oin two. Rotational malalignment 10o was encountered in five patients

Floating knee with ipsilateral floating hip injury equivalent variant: a Case report

This report describes a rare case of concomitant ipsilateral pelvic disruption; hip dislocation; a femoral shaft fracture; supra and intercondylar fracture of the femur; and tibial shaft fracture in ayoung man who suffered a fall from a moving truck. The hip dislocation was reduced under general anaesthesia with a closed procedure. Both femoral shaft and distal femoral fractures were reduced and stabilised with a Judet screw-plate via a posterolateral approach to the femur. The other fractures were treated conservatively. Emphasis was placed on the complex injury around the hip.The surgical management of this constellation of injuries combining a floating knee and a variant of floating hip is discussed in the light of the current principles of management of a multiply injuredpatient. The authors propose the inclusion of the peculiar injury pattern occurred around the hip in the existing classification systems for floating hip