[Use of Hoffman external fixation for extra-articular upper metaphyseal tibial fractures]

Treatment of extra-articular upper metaphyseal tibial fractures can be difficult. Orthopedic treatment is frequently complicated by second displacement. These fractures are inappropriate for locked intra-medullary nailing because of the shorteness of the proximal extremity. Damages of soft tissues, frequently associated with these factures, expose internal osteosynthesis to many risks. For these reasons, we opted for external fixation. Our study was a retrospective analysis of 46 extra-articular metaphyseal tibial fractures treated by external fixation with Hoffman material. The average follow-up was 24 months. Consolidation was obtained within 4 months in average. Septic complications, inherent to the method were uncommon or minor. Functional results were satisfactory in 84% of cases. So, external fixation with Hoffman material, with particular recommendations, is a promising method for the treatment of extra-articular of proximal metaphyseal tibial fractures

[ results of anterior cruciate ligament reconstrution by bone - patellar tendon - bone technique. a series of 40 cases]

We reviewed retrospectively 40 patients treated surgically for rupture of anterior cruciate ligament. The technique used was arthroscopy bone patellar tendon reconstruction. The mean age of patients was 27 years. The operative delay was 27.2 months in average. Functional and anatomic result was evaluated with a mean follow up of 24 months. 80% of patients were classified IKDC A or B. Sports activity was resumed after 6.6 months in average. Results depented meniscus lesions and operative delay. Reconstruction of anterior cruciate ligament with bone patellar tendon bone is a reliable technique. Operative delay should be as short as possible to prevent meniscus lesion and aggravation of laxity