The results of internal fixation of three- and four-part proximal humeral fractures with the Polarus nail.

Twenty-three patients with acute displaced three- and four-part fractures of the proximal humerus, including seven patients with associated shaft involvement, were treated with the Polarus intramedullary interlocking nail using a closed technique. At the 1-year follow up, the median Neer scores were 89 and 60 for the three- and four-part fractures, respectively. Three patients (13%), all of whom were in the four-part group, continued to have significant pain at final review. We found the implant to be extremely satisfactory and particularly useful in the treatment of combined neck and shaft fractures of the humerus.

Traumatic prepatellar neuralgia.

Fourteen patients with painful knees caused by a direct blow to the front of the knee have been studied. The exact diagnosis was often delayed. Apart from pain, all patients had one common feature which they may not have been aware of, namely, marked tenderness localized towards the middle of the outer border of the patella. Surgical treatment in 11 patients, by excision of the subcutaneous tissue in the tender area and the prepatellar bursa, cured all cases. Histology of the excised specimens confirms the existence of a definite clinico-pathological entity.

Intramedullary interlocking nailing for humeral fractures: experiences with the Russell-Taylor humeral nail.

The Russell-Taylor intramedullary interlocking nail has been used on 39 patients with fractures that occurred at various levels of the humerus. Thirty patients had acute fractures and nine had pathological fractures. Twenty-five patients with acute fractures were re-examined after their fractures had united and assessed according to Neer's classification of shoulder function. Twenty-two (88 per cent) had excellent and satisfactory shoulder function. Pain relief was achieved in all pathological fractures. Shoulder pain encountered in a few patients in this series, where nailing was performed by the antegrade route, was mainly due to problems associated with the proximal interlocking screw.

Quadricepsplasty following femoral shaft fractures.

The results of 12 quadricepsplasties performed on 10 patients with stiff knees following united femoral shaft fractures are reviewed. All fractures were caused by high-velocity road traffic accidents and were associated with a variety of features which led to multiple operations and delayed union. The increased range of flexion achieved in this series is higher than in those reported previously.

Traumatic hemipelvectomy: a further case report and comments on management.

The fourteenth case of survival following traumatic hemipelvectomy is presented. Several features of these massive injuries are illustrated by this case report and provide an opportunity to suggest guidelines of surgical management, based on standard and new criteria.

Dislocation of both interphalangeal joints of one finger.

A rare type of dislocation involving both interphalangeal joints of one finger is described. The mechanism of injury is discussed, and the importance of immobilizing the finger in the correct position is stressed.