Antegrade interlocked humeral nailing for stabilization of humeral fractures was introduced many years ago, and studies on this method in the orthopedic literature have shown mixed results. The purpose of this investigation was to document the clinical outcome and complications associated with the use of an antegrade intramedullary nail (T2, Stryker) for the humeral fractures. Between 2005 and 2008, 52 fractures of the humeral shaft were treated operatively with this intramedullary nail in our department. Eight patients were polytraumatized, and four patients had an open fracture. The mean age of patients was 51.7 years. Forty-eight patients had an adequate duration of clinical follow-up (a mean of 18 months) for analysis. Complications were recorded, and the time to union was measured. Shoulder and elbow functions were assessed using the Constant Score and the Morrey Score, respectively. Forty-six fractures healed, with a mean time to clinical union of 10.3 weeks. Two patients developed pseudarthroses. There were four adverse events: two proximal screws backed out, one superficial infection at the insertion point, and one fracture at the distal end of the nail. Ninety-one percentage of patients had an excellent or good shoulder function. Five further operations were necessary: two for treatment of pseudarthroses, two for removal the backed out proximal screws, and one wound debridement for superficial infection. Antegrade humeral nailing is a valid therapeutic option for stabilization of humeral shaft fractures. By strictly adhering to the operation technique, the number and the severity of complications can be reduced. When good fracture alignment and stability are obtained, uneventful bone healing with good functional results is the rule.
The study aims to evaluate the treatment of moderate to severe forms of hallux valgus with the lowest invasiveness in soft tissues and especially with an alternative modified Chevron osteotomy of the first metatarsal. Additionally, it emphasizes the necessity of the modified McBride procedure (capsuloplasty and release of specific concrete soft tissue structures) and the importance of the soft tissue manipulation in the particular surgery intra-operatively, as well as postoperative medical and personal care and duration of rehabilitation. Patients with an average age 58 years (range 51-65), who underwent a Chevron type osteotomy with combination of soft tissues interventions laterally and medially of the first metatarsophalangeal joint, for symptoms they had of systematic hallux valgus without any other degenerative problems in metatarsophalangeal joint between 2017 to the beginning of 2018, were retrospectively reviewed with an average follow-up of 29 months (range 26-31).
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