[Fixation of the tuberculum in multifragment fractures of the proximal humerus treated with hemiarthroplasty].

Hemiarthroplasty is an effective treatment for multifragmentary fractures of the proximal humerus. Purpose of this study was to compare 2 different methods of tuberosity dislocations,which is one of the primary reasons for successful posttraumatic arthroplasty. Between 2006 and 2008, 29 patients with multifragmentary fractures of the proximal humerus underwent hemiarthroplasty of the shoulder. Mean gae was 69y., while mean postoperative follow up was 27 months. We evaluated two different techiques of tuberosity fixation after anatomic reattachment on humeri: (A) intertuberosity suture stabilization around the prothesis, and their suture to the humeri and (B) direct intertuberosity suture and their suture to the humeri Postoperartive Constant score averaged 71 points. Reason for failure of the operative treatment was primary due to the postoperative tuberosity migration It was noted in all patients of group 2 and in 2 patients of group 1. Intertuberosity stabilization using sutures arpund the prothesis and tuberosity fixation to the humeri was proofed to be optimal method, because it decreased strain and mobility of tuberosities, maximize stability of the hemiarthroplasty and facilitate postoperative rehabilitation.

Unusual position of bone tunnels in failed ACL reconstruction.

INTRODUCTION: Surgery of ACL deficient knees is very frequent nowadays due to advanced surgical techniques, sophisticated implants and large number of surgeons. Therefore, the number of revisions for various reasons is growing up. There are several well known reasons for failed surgery This paper reported a case of revision surgery in a patient with previously done and failed reconstruction of ACL. CASE OUTLINE: Reviewing the clinical findings and X rays we found out peculiar position of the transplant and tunnels as a cause of the failure. We haven't found such complication reported in literature therefore we decided to report the case. CONCLUSION: Variety of implants and instruments can ease the surgery but basic anatomical knowledge of position and relations of the knee ligaments are essential for good surgical outcome.