Aims: Review the results of Long Gamma nail in the treatment of a select group subtrochanteric meta-static lesions of femur. Methods: From 1996 to 2002, 34 patients with subtrochanteric metastatic lesions of femur treated with Long Gamma Nail were included in this retrospective study. Hospital records and x-rays were reviewed for collecting the data. Results: 37 met-astatic femoral subtrochanteric lesions (3 bilateral) in 34 patients, 17 male and 19 female, with an average age of 65 yrs, had reconstruction with Long Gamma Nail. Right femur was affected in 15 and left in 22. Most common primary cancer was breast in 15, prostrate in 5, lung in 5, and others in 9 cases. Prophylactic nailing was preformed in 28 femurs (75%) and nailing of actual fracture in 9 femurs (25%). All femurs had distal locking bolts except in 2. Postoperatively pain relief was achieved and pre-op mobility was regained in all patients. 5 patients (13.5%) had medical complications including a death due to chest infection. 4 patients (10%) had implant related complications but none required any further surgery. There were no implant failures. From the time of surgery 20 patients (60%) died with a mean survival of 9 months, and 13 patients (40%) are alive, pain free and independent with a mean survival of 18 months. The overall patient survival rates after operation are 73% at 6 months, 56% at one year and 40% at 4 years. Conclusion: Reconstruction of met-astatic subtrochanteric femoral lesions with long gamma nail is highly effective in achieving local pain control, restoring limb function and better quality of remaining life with acceptable rate of complications.

Introduction: Osteoid osteomas (OO) are benign skeletal tumours with a predilection for the long bones of young patients. Many different methods are used for their treatment, conservative or operative, less or more radical with variable technology applications to destruct the “nidus”.

Material & Method: We present thirty eight patients with OO who were treated in our hospital between 1995–2001. Their medical records and radiographs are retrospectively reviewed and the patients were contacted and interviewed with a telephone discussion.

Results: In thirty two cases OO were located in the lower limb, two in upper limb and four in spine. Thirty seven of those were treated operatively using open wide excision of nidus in twenty two of which with additional bone grafting.In three of the cases after excision of OO, precautious internal fixation was applied to the bone. Two patients developed deep vein thrombosis, another two had increased pain in anterior superior iliac spine from the bone graft harvesting area. We had one recurrence, which was treated with a second operation.

Conclusion: We conclude that although the traditional method of treatment is the wide surgical excision, this technique has increased morbidity and higher risk for complications comparing to more minimally invasive procedures. We suggest that it should be the first choice of treatment for either spinal or recurrent OO.

Introduction: Enchondromas are benign cartilaginous tumors, which are most often localized, in the small bones of the hand. Treatment methods fall into a broad spectrum ranging from conservative, medical therapies, to a variety of surgical procedures, which may or may not employ the use of local adjuvant treatment or bone grafting.

Material & Method: We present thirty four patients with hand enchondromas treated surgically in our department during the last eleven years. Their medical records and radiographs were reviewed retrospectively and the patients were contacted and interviewed by telephone.

Results: The patients were treated operatively with an intralesional approach, with meticulous curettage of the bone lesion, use of phenol 5% and grafting using coralline hydroxyapatite. X-rays taken over the first postoperative year revealed adequate bone synthesis at the site of enchondroma excavation, and there was no evidence of recurrence, fracture, infection or other complication related to the procedure.

Conclusion: We conclude that the combination of curettage of the lesion with the use of phenol as local adjuvant and grafting using coralline hydroxyapatite during the surgical treatment of enchondromas, is a safe technique to reduce or prevent recurrence and allow adequate and uncomplicated local new bone formation.