Minimally invasive plate osteosynthesis for comminuted femoral fractures

This prospective study presented 27 male patients with unilateral closed comminuted femoral fractures treated by the minimally invasive plate osteosynthesis technique. They were 6 subtrochanteric, 3 diaphyseal and 18 distal fractures. Indirect reduction was done without exposure of the comminuted fragments. Two separate incisions were used for sub-muscular insertion of the plate. DHS was used in 7 cases, broad DCP in 2 cases and condylar buttress plate in the 18 distal fractures. The mean follow-up interval was 18 months [range 9-28 months]. All fractures united [100%] without bone grafting alter a mean interval of 4.3 months [range 3-5 months]. No cases of nonunion or infection were reported. According to Neer's scale, the results were excellent and satisfactory in 24 cases [88.9%] and unsatisfactory in 3 patients [11.1%] with no failures. Few complications occurred in the form of 1 cm shortening in two cases and 10 degrees valgus in two cases. The minimally invasive plate osteosynthesis technique proved to be useful for treatment of comminuted femoral fractures, especially those in which the interlocking nail can not be used. It is technically not difficult, has a high rate of success and low incidence of complications

Non invasive treatment of common bile duct obstrucion

The study comprises 28 patients with obstruction of the common bile duct [CBD]. Twenty patients with calcular obstruction, these included 5 patients with missed stones in the CBD following cholecystectomy, 4 patients with malignant obstructive janudice and 4 patients with benign stricture of the CBD. All patients were subjected to full clinical examination and basic investigations, and liver function tests. Serum bilirubin and alkaline phosphatase were elevated in all patients. Abdominal ultrasonography was done and diagnostic endoscopic retrograde cholangiopancreatography with side viewing endoscopy was done to all patients. By the use of the endoscopic retrograde cholangiopancreatography, the cases of calcular obstruction of CBD were extracted by papillotomy and dormia basket or with a balloon. This procedure was successful in 17 patients out of 20. In cases presenting with stricture of the CBD failure of cannulation occured in 3 patients out of 8 and in the remaining 5 patients papillotomy with fixation of endoprosthesis was performed. All failures were surgically treated. Short and long term follow up showed satisfactory results as assessed by clinical and biochemical means

role of postoperative irradiation in intracranial menlngloma

Ninety five patients with intracranial meningioims were included in this study. Total surgical removal was done in 51 patients and partial removal was done in 44 oases. Postoperative radiotherapy was applied in 63 oases depending on the extent of surgery and/or histologioal findings. Objective complete response was achieved in 67/95 of the cases. The 5 year actuarial survival rate was 93.8% in -cases with limited disease treated by complete removal alone, 89.5% in malignant types treated by complete removal and postoperative radiotherapy and 87.5% in patients whose tumours were incompletely removed and treated by radiotherapy