Percutaneous cannulated screws fixation in displaced intracapsular fractures of the femoral neck

The results of percutaneous cannulated screws fixation in 20 patients with displaced intracapsular femoral neck fractures were evaluated. 15 patients [75%] had partially displaced fractures [Garden III] and 5 patients [25%] had completely displaced fractures [Garden IV]. The mean age of the patients was 42 years [range 22 to 60 years]. The mean duration of follow-up was two years. Closed reduction was successfully done in all patients using Whitman maneuver and under image control. Cases with failed closed reduction were excluded from the study. All patients were evaluated on the basis of both clinical and radiological examinations. No patient died or had a wound infection during stay in the hospital. There was non-union of the fracture in two patients [10%] and healing of the fracture in 18 patients [90%]. The final results were graded as excellent in 12 patients [60%], good in 6 patients [30%], fair in one patient [5%], and poor result in another patient [5%]. Avascular head necrosis developed in 2 patients [10%], both had Garden type IV fracture. Another one patient [5%] with fracture [Garden III united in varus although she was functionally classified as good. Percutaneous cannulated screws fixation of intracapsular femoral neck fractures could offer a safe, simple, and effective procedure with good union and low rate of morbidity and mortality

Evaluation of the results of external fixation of femoral shaft fractures in children

Thirty-four patients with 35 femoral shaft fractures were treated using the AO unilateral external fixator after reductionfrom 1999 through 2000. Thirteen girls and 21 boys were the material of this study. The average patient age at presentation was 9.5 years [range 6-14 years]. There were 16 children with multiple injuries whereas 18 children had isolated femoral shaft fractures. All the fractures were followed until union, with an average time of external fixation of 75 days. The average follow-up was 1.5 years. All the fractures healed without additional surgical intervention. There was minimal angulation at the fracture site with an average of 4.5 degrees in the anteroposterior plane and 4.6 degrees in the lateral plane. Although pin tract infection was common [10 cases], nine of them resolved with a broad-spectrum oral antibiotics, only one patient required inpatient intravenous antibiotics. No patient developed osteomyelitis. 24 patients had clinically equal leg lengths, 9 patients had clinically less than 10 mm of inequality and only one patient had 15 mm discrepancy. We had no re-fractures after removal of the fixator, We agree with previous reports that external fixation remains a viable option for the treatment of femoral shaft fractures in children with multiple injuries. It is also an effective means of treating isolated femoral shaft fractures in the pediatric population