Placement of the distal locking screws of the femoral intramedullary nail without radiation.

An H-shaped device was invented to facilitate placement of the distal interlocking screws during closed femoral nailing. Eleven sound cadaveric femurs were experimentally nailed before the application of the device in 15 patients with a femoral shaft fracture. In all experimental cases the insertion of the distal screws proved to be easy. In 11 of 15 patients with a femoral fracture, distal locking was achieved using the H-device. These primary results should stimulate further clinical application of the device.

Dislocation of the shoulder and ipsilateral fracture of the humeral shaft: case reports and literature review.

Shoulder dislocation associated with ipsilateral humeral shaft fracture is an uncommon combination. Two cases treated, one by open and the other by closed methods, are presented. The mechanism of this complex injury is detailed and the treatment modalities are discussed. The relevant literature is reviewed.

Correct placement of the screw or nail in trochanteric fractures. Effect of the initial placement in the migration.

This is a prospective study of 106 patients with 37 stable and 69 unstable trochanteric fractures treated with 2 different implants: a sliding screw-plate and a triflanged nail-plate. The fractures were classified according to Jensen's modification of Evans classification. The parameter migration was compared between the 2 implants and for the various areas of placement of the screw or nail within the femoral head. For stable fractures, the migration observed was independent of the area of implant placement or the type of implant used. For unstable fractures, central placement of the sliding screw resulted in a decreased mean value of migration. When the nail was used, the mean values of migration observed were independent of the areas of placement within the femoral head. In cases of central placement, the sliding screw appeared to be superior to the triflanged nail.