Treatment of nonunions of humeral fractures with interlocking intramedullary nailing / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To introduce the experience of treating nonunions of humeral fractures with interlocking intramedullary nailing.</p><p><b>METHODS</b>Twelve patients with humeral nonunions were treated with interlocking intramedullary nailing. The time interval between trauma and surgery was 10.5 months on average. Open reduction with anterograde approach was performed. Axial compression was specially applied to the fracture site with humeral nail holder after insertion of distal locked screws. Iliac bone grafting was added.</p><p><b>RESULTS</b>The average follow-up period was 21 months (ranging 9-51 months). All patients achieved osseous union 5.8 months after treatment on average. Eleven patients had good functions of the shoulder joints and the upper extremities. No patient experienced any permanent neurological deficit. Refracture of the original ununited region occurred in one patient after removal of the internal fixator one year later, but union was achieved after closed re-intramedullary nailing fixation.</p><p><b>CONCLUSION</b>Humeral interlocking intramedullary nailing is an effective alternative treatment for humeral nonunion.</p>

Treatment of ipsilateral femoral neck and shaft fractures / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the clinical characteristics, treatment options and causes of misdiagnosis of ipsilateral femoral neck and shaft fractures.</p><p><b>METHODS</b>Among 20 patients with ipsilateral femoral neck and shaft fractures, 19 were treated operatively and 1 was treated conservatively. Sixteen cases of femoral shaft fractures were treated by open reduction and internal fixation with compressive plate, and 2 cases were treated with interlocking intramedullary nailing. Eighteen femoral neck fractures were treated with cannulated screws. Another patient was treated with proximal femoral nail to fix both the neck and shaft. Delayed diagnosis for femoral neck fractures occurred in 2 cases preoperatively.</p><p><b>RESULTS</b>A total of 19 patients were followed up. The follow up period ranged from 5 to 48 months with an average of 15 months. All the fractures were healed.</p><p><b>CONCLUSION</b>For case of femoral shaft fracture caused by high energy injury, an AP pelvic film should be routinely taken. Once the femoral neck fracture is recognized, operative reduction and fixation should be performed in time. Femoral neck and shaft fractures should be fixed separately.</p>