Purpose of the study: To compare the DHS plate fixation with the Targon PF nail for the treatment of intratro-chanteric fractures.

Material and methods: This was a prospective randomized study including 60 patients hospitalized in the emergency setting between December 2003 and June 2004for intratrochanteric fractures. The AO classification was used. We analyzed: patient status (ASA), operative time (type of implant, duration), the postoperative period (blood loss, radiologic findings, duration of hospital stay, early postoperative complications) and at last follow-up, Harris hip score, date of resumed walking, mortality. Patients were assessed at three months postop. This study included 60 patients, 34 with a Targon PF nail and 26 with a DHS. Mean patient age for nailing was 81 years (SD 12.8, range 23–86); for DHS it was 82 years (SD 9.8; range 47–97).

Results: Mean blood loss was 410 ml with the Targon PF nail and 325 ml with the DHS, a nearly significant difference (p=0.07). The other results did not demonstrate any significant difference. At three months five cases of screw cut out were noted. Bone healing was achieved in all cases. The Trargon PF nail and the DHS provide equivalent results, with less bleeding an lesser cost for the DHS.

Purpose of the study: Reconstruction of the anterior cruciate ligament (ACL) has become a common procedure. We compared two randomized series: intra-articular (Kenneth-Jones) versus intra- and extra-articular (MacInJones).

Material and methods: From January 1995 through March 1998, 73 knees were treated surgically for differential medial laxity measured at 7 to 12 mm on passive stress x-rays in 20° flexion. Group 1 (ACL reconstruction alone) included 34 patients (aged 27.1±7.5 years). Group 2 (ACL reconstruction plus extra-articular plasty) included 29 patients (aged 28.5±12 years). Function was scored 72% in group 1 and 68% in group 2 at mean seven years follow-up (102 and 93 months follow-up respectively). Anterior laxity was measured radiographically and with KT-1000 and the position of the tunnels was assessed according to Aglietti.

Results: According to the IKDC, functional outcome was 83.9±3.1 in group 1 and 83.3±3.6 in group 2. The overall IKDC classification was 0A, 57.8% B, 26.3% C, and 15.7% D for group 1 and 58% A, 52.9% B, 29.4% C, and 11.7% D for group 2. The pivot-shift test was negative in 61.1% of group 1 knees (27.7% grade 1 and 11.1% grade 2) and negative in 83.3% of group 2 knees (16.6% grade 1). In group 1, the radiological drawer showed 46.09% improvement in the differential laxity for the medial compartment and 41% for lateral compartment. In group 2 the corresponding improvements were 44.8% and 44.6%. There was no difference in tunnel position between the two groups.

Discussion: The two-year results of this series did not provide any evidence favoring a clear advantage of complementary lateral plasty. At seven years follow-up, the pivot-shift test appeared to favor associated lateral plasty (p=0.09), but with no significant difference in laxity for the two compartments.

Conclusion: Anterior laxity was only incompletely controlled by both reconstruction techniques. In this context of relatively limited laxity (7–12 mm initially), at seven years follow-up there was no certain advantage of complementary lateral extra-articular plasty in combination with ACL reconstruction.