To assess the outcome of Wilson’s osteotomy of the first metatarsal to correct Hallux Valgus.

Two hundred and forty feet in 172 patients who had surgery for pain were reviewed clinically and radiologically. Age ranged from 28 to 82 years (mean 55 years) and duration of follow-up ranged from 2 to 15 years (mean 6 years). A mini external fixation was used to stabilize the osteotomy.

The average AOFAS score improved from 51.6 to 89.5 points at the last follow-up. In 96% of the cases, the final outcome was satisfactory as far symptomatic improvement was concerned. A 4% only was dissatisfied with the outcome of the surgery due to metatar-salgia, restricted first metatarsophalangeal joint motion or lack of correction. There were no cases of avascular necrosis of the metatarsal head. We had five cases of delayed union but they didn’t need further surgery.

The average preoperative HVA and IMA were 34.80 (range: 180–540) and 15.10 (range: 100–290), while the average postoperative HVA and IMA were 16.10 (range: 70–280) and 7.20 (range: 30–90) respectively.

Wilson’s osteotomy as a method of treatment of Hallux Valgus is technically straightforward, effective and with a predictable outcome. We believe that the external fixation offered increased stability at the osteotomy site and could be the reason why patients had a very low incidence of postoperative metatarsalgia and returned to their normal activities faster, thus giving a higher satisfaction rate.

The aim of our study was to examine the outcome of ACL reconstruction by using four strand hamstring tendon autografts.

Material and Methods: the study included 44 patients (29 males,15 females;mean age 26;18–45 years). The diagnosis was based on clinical examination and imaging techniques. The operation was performed arthroscopically 4–62 weeks after the injury. The tendon was fixed in the tibia with an interference screw and in the femur with three different methods cross pin in 16 cases, transfix pin in 11 cases and Endo button in 17 cases.

Results: The mean follow up was 28 months (12–42). The mean Lysholm score was improved from 35–65 (mean 49) preoperativelly to 55–100 postoperativelly (mean 88).

5 patients had laxity > 3mm when compared to the healthy knee by using the KT-1000 arhthrometric testing. 2 of the latter patients complained of a feeling of knee joint instability which occurred due to inaccurate positioning of the femoral tunnel. In 2 cases the transfix pins were displaced and removed on the 4th and 15th post-operative month.

The tunnel expansion was measured by an X-Ray or a CT scan. The tibial tunnel expansion was 0–2.5mm (mean 1.2) or 18% and the femoral tunnel expansion was 0–3 mm (mean 1.4) or 26%. 8 patients reported mild pain which did not restrict their activities. A 5 degree loss of extension was noticed in one patient who continues physiotherapy.

28 of the above patients suffered also from a meniscal injury that was managed arthroscopically.

Conclusion: ACL reconstruction by using four strand hamstring tendon autografts is safe, highly successful with very few complications when proper graft preparation and accurate tunnel placement is achieved.

Purpose: To present/evaluate the results of ‘intramedullary hip screw’ (IMHS) for treatment of subtrochanteric fractures of the hip.

Materials and Methods: Between 2003–2005 fifty four (54) patients aged 62–92 years old (average: 77,3 yrs) with subtrochanteric fractures of the hip were treated in our department with intramedullary hip screw (IMHS). Thirty one (31) patients were women and twenty three (23) were men. Thirty (30) fractures were located in the right hip and the remaining twenty four (24) in the left one. All patients were operated by the same surgical team –within 3 days from injury in the 86% of the cases. The duration of the procedure was between 55–75 minutes. Post-op, the patients were mobilized early with -at least–partial weight bearing and they were followed-up -clinically and radiologicallly for 7–30 months.

Results: 85% of the fractures were united within 14 weeks uneventfully. In seven cases, bone grafts were used. Three (3) cases of superficial wound inflammation and two case of haematoma were noticed. All above cases were treated successfully. Neither femur’s fractures (near or distal to the tip of IMHS) nor failure of implants were noticed. The 75% of patients achieved the pre-op status of rehabilitation.

Conclusions: The results of this study show that ‘intramedullary hip screw’ (IMHS) seems to be a reliable treatment for the subtrochanteric fractures of the hip; and it could be considered as one of treatment of choice for them.