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We investigated the results of surgical treatment of 49 trochanteric femoral fractures using the compression hip screw.The patients included 13 males and 36 females, with the mean age of 83 years. According to the classification of Evans, 33 cases were stable and 16 cases were unstable.Local complications were observed in 2 cases; loosening of the lagscrew in 1, cutting out with rotational displacement in 1. The telescoping amount of the lagscrew was significantly (p

A retrospective clinical and radiographic analysis was perfomed on 5 patients who were treated with lateral mass plate. The average patients age was 46.8 years (range, 22-78 years), and the average follow-up period was 10 months (range, 3-20 months). Three patients with dislocation and fracture of the cervical spine were treated with posterior plate without bone graft, and with decompression and anterior plate with iliac crest bone graft. One patient with C456 body fracture and C345 lamina fracture was treated with posterior plate with bone graft. One patient with cervical myelopathy with athetosis was treated with long posterior plate (C2-T1) with bone graft. After surgery, the patient's neck was protected with a soft collar while in bed, and a philadelphia collar was worn when ambulating for the first month, then a neck collar for Next two months. Solid arthrodesis was achieved in all. No patients experienced neurological deterioration. However, some loosening screws and some malpositioned screws were found by the CT scans and X-ray, due to poor operative technique. Although there was no clinical symptom, one patient underwent additional operative procedure to replace two screws. We conclude that lateral mass plating is a good method for cervical spine stabilization if we are able to master the surgical technique well.

We report four cases five toes with hallux sesamoid lesions which were treated using sesamoidectomy. In this report, the surgical technique for such disorders and the differentiation between osteonecrosis and fracture of the sesamoids are discussed.All toes had the same histological findings consisting of necrotic bone and fibrocartilaginous material making it difficult to discriminate histologically between osteonecrosis and fracture. We used clinical criteria to diagnose sesamoid fracture in which subjects recalled any strenuous activity or minor trauma due to sesamoid pain. Finally two fractures and three osteonecroses were diagnosed, treated and followed.At surgery we recommend a medial midline incision and plantar approach to the sesamoid without a medial capsular incision as this method may help to prevent hallux deformity and reduce the abutting of the digital nerve by the sesamoid.

Cubitus varus deformity is the most common complication following supracondylar fracture of the humerus in children. It has been said that the deformity is related to rotation of the distal fracture fragment. However measuring rotation by X-ray is too difficult.To investigate the causes of cubitus varus we measured carrying angle (C. A.), tilting angle (T. A.) by X-ray, and humeral torsion (H. T.) using ultrasound in 33 cases treated in our hospital from 1977 to 1992 following supracondylar fracture of the humerus. To measure the H. T., which has been already described by Ito the patient is positioned in a supine position with the elbow in 90 degrees of flexion, and the probe placed on the bicipital groove. The shoulder is then rotated until the bicipital groove faces upward. The angle between the axis of the forearm and perpendicular line of the examination table is considered as the H. T.. C. A., T. A. and H. T. of the fractured side were compared with the healthy side.There was a positive correlation between C. A. and H. T.. However no such relationship was found between T. A. and H. T..