Breakage of a Lag Screw of Cephalomedullary Nail: A Technique of Removal

A broken lag screw of the cephalomedullary nail is a rare condition. Removal of the retained lag screw from the femoral head is also very challenging. This article describes a surgical technique and the modified instrument that was available in the operating room for removing the broken implant by closed technique.

Image-based Navigation in Orthopaedic Surgery

Image-based navigation is recently accepted as one of the most profitable devices utilized to improve the accuracy of many procedures in orthopaedic surgery. Actually, navigation-assisted surgery systems were initially used in neurosurgery in the late 1980s. The interactive computer system is able to match the co-ordinate pre-or intraoperative images, patient’s anatomy and the surgical instruments by using tracking and registration process. The initial image-based navigation system has based upon preoperative computer tomography (CT) images and clinical application has been successfully introduced in spinal instrumentation since 1994.1-2 However, time consuming, comsplicated techniques and error in the registration process known as a pair-point matching remain the major concern and may cause CT-based navigation less popularity with time.

Review Article Initial Management of the Injured Elderly

It is well recognized that the proportion of the elderly is increasing. The population who are older than 65 years will become 52 millions by the year 2020. The number may exceed 68 million by the year 2040.1 Many of these elderly will sustain an injury during their lives and trauma in this age group usually relate with higher mortality rate than do in the adult. Except heart disease, cancer, chronic obstructive pulmonary disease (COPD), stroke, diabetes and pneumonia, trauma is the seventh leading cause of death in the geriatric patients. Even though the elderly are less likely to be injured than the younger, the fatal outcome, 28% of all fatal injuries in the United State, are more likely in this age group.2,3 This evidence probably reflects the decreased physical reserves of the elderly due to the physiologic changes of aging, the developed co-morbidities and a lack of understanding of specific treatment by many health care providers.