Early and safe mobilization remains the mainstay of treatment for the intertrochanteric fractures. Many implants have been used but the intramedullary implants seem to provide maximum stability in unstable fractures. The aim of this study was to compare two intramedullary devices which have different philosophy and modes of action.

Between 01.07.2005 to 30.06.2007, 110 patients with trochanteric fractures treated with the intramedullary hip screw (IMHS, Smith & Nephew) nail and 105 with the ENDOVIS (Citieffe) nail. The data recorded were the fracture’s type, preoperative hemoglobin level, pre-fracture walking ability. Postoperatively were recorded the operative time, the level of hemoglobin on the first day, mobility status, complications and 12 months mortality rate. The results were comparable regarding blood loss, operative time, and mortality rate. However, the rehabilitation and functional outcome were superior in the IMHS group. This probably was attributed to the higher number of complications of the ENDOVIS nail.

IMHS is a valuable tool for the treatment of stable intertrochanteric fractures, offering also excellent results in the management of reverse obliquity, comminuted fractures and those with a subtrochanteric extension. Further investigations are necessary to prove which the ideal intramedullary implant is. However, it seems that devices combining the principles of the sliding hip screw with those of an intramedullary nail present safe and accurate fixation, fewer mechanical failures and exceptional functional outcomes

Fractures of metacarpals and phalanges are common in hand injuries. The goal of treatment is the immediate mobilization of the fingers and restoration of the hand anatomy thus avoiding contractures of the metacarpo-phalangeal and phalangophalangeal joints and hand dysfunction. The aim of this study is the comparison between two methods of fixation of these fractures.

Between 2000–2007, 74 patients who suffered meta-carpophalangeal fractures were treated by K-wires and 62 patients were treated by mini external fixation. Parameters recorded were the operating time, postoperative range of motion, cost and complications. The surgical time was lesser with the use of K-wires, the operative technique much simple and the cost minimum as compared to mini external fixators. The postoperative range of motion was inferior with the external fixation. However, there was no statistical difference between the two groups. 2 patients with the external fixation and 1 patient with K-wires developed pin-track infection. There were 3 failures of fixation in the external fixator group but no failure occurred with the use of K-wires. The majority of the fractures healed within 6 weeks.

K-wires seem to be the ideal method of treatment considering the fractures of metacarpals and phalanges. The use of mini external fixation presents many disadvantages and probably is restricted to the treatment of the open and comminuted hand fractures.