Purpose: The intramedullary nailing is the treatment of choice for the femoral shaft fractures, giving advantages of early mobilization and weight bearing.

The purpose of this study is to present our experience with numerous reamed femoral nails and to report the results and the complications.

Material and Method: From 1993 to 2004, 415 femoral shaft fractures (413 patients) were treated in our hospital. There were 312 males 101 females with mean age was 27.8 yrs (17–84 yrs). The 87 % of fractures were caused by high-energy injuries (traffic accidents). Pathologic fractures were not included.

The 415 fractures according to AO classification were divided as follows: Type A: 105 (25.4%), Type B: 179 (43.1 %), Type C: 131 (31.5 %) There were 341closed fractures and 74 open. Those 74 were classified according Gustilo to 33 Grade I, 24 Grade II, 14 Grade III A, 2 Grade III B and 1 Grade III C.

The fractures were treated with 308 AIM titanium nails and 107 Gross-Kempf nails. Dynamic stabilization was performed in the majority of the type A fractures, and static to those classified as B and C. We encourage our patients to walk with partial weight bearing, from the second post op day, except those with type C fractures who started their weight bearing after a month.

The patients were evaluated 3,6,12,36 weeks and 1 years post surgery clinically and with standing X-Rays.

Results: After a mean follow-up time of 1.5 years, our union rate was 97.8%. Type A fractures were united in an mean time of 16 weeks, type B in 20 weeks and type C in 23 weeks.

Our complications were: 9 non unions (aseptic pseudarthrosis) (2.2%), 14 delayed unions (3.4 %), torsional malunion (more of 5°) in 4 patients (0.96 %). In 6 patients (1.44 %) we had limb shortening of 15 mm. Neurological complications were observed postoperatively in 30 patients, 25 with paresis of the pudendal nerve, due to traction (all recovered in a month), and 5 with paresis of peroneal nerve which were recovered in 3 months. There was found 28 broken screws but no broken nail. We had 3 pulmonary and 2 fat embolisms, but none of them was fatal. In 4 patients was observed clinically vein thrombosis below knee. Also we noticed one superficial and one deep infection, but we didn’t have a case of compartment syndrome.

Patients returned to their previous activities in a mean time of 10 months.

Conclusion: Our results confirmed that the antegrade intramedullary nailing technique had optimal results and high union rate regarding the treatment of the femoral shaft fractures. Some of the complications could be related with the surgeon’s skills-experience and could be avoided. We prefer the use of titanium nails because their modulus elasticity is closer to bones.

Aim: The description of technique and early results of arthroscopic rotator cuff tears (RCT) reconstruction.

Patients-Methods: Âetween 01/2001 and 02/2003 26 patients, ranging in age from 33–82 (mean age 61,5 y.) – 17 males, 9 females – with RCT underwent arthroscopic reconstruction including debridement, sub-acromial decompression and mobilization of the rotator cuff. The RCT was then repaired with the arm in neutral position using “side to side” suturing technique and rotator cuff anchors when needed. Postoperatively, rehabilitation program included initially passive, active kinisiotherapy while exercises under resistance were finally performed..

Results: All patients were evaluated using ASES and UCLA scores pre-and postoperatively. Pain relief postoperatively was noticed in almost all reconstructed patients. In order to indentify functional improvement range of motion and strength were seperately evaluated. Range of motion just as pain remission was notably improved in almost all patients while strength ameliorate most in patients with complete restoration of rotator cuff tear. The interval between reconstruction and full patients’ recovery ranged between 3 months – pat. < 60 years – to 6–8 months – pat. > 60 years.

Conclusions: Arthroscopic RCT reconstruction although a demanding technique achieves satisfactory early results—mainly regarding pain relief and range of motion improvement- comparable to those of open repair reducing also postoperative morbidity.