Introduction: Metacarpal and phalangeal fractures are frequent (13% of the total number of fractures). It seems that the best treatment for the displaced fractures is fixation. Various methods have been used, such as plates and screws, wires, IM-nailing, external fixation. The main problems are adhesions of extensor tendons, scarring and stiffness of the joints.

The purpose of this study is to examine the efficacy of internal fixation using Kirschner wires, applied open or closed, treating metacarpal and phalangeal fractures.

MATERIALS AND Methods: Between 1998 and 2005 145 out of a total of 2848 (5.2%) metacarpal and phalangeal fractures underwent operative treatment. Fixation was achieved by placing extrarticularly two or more Kirschner wires.

The wires were removed after 4 weeks and patients underwent physiotherapy for 2 to 4 weeks. The follow-up period was 3 – 15 mos (average 12 mos) and total range of movement and function of the injured hand was evaluated.

Results: Bone union was evident in 3 to 5 weeks. Range of movement was approximately 90% of normal, except for cases of comminuted intraarticular fractures and also in 6 cases of elderly non-cooperative patients.

One case of infection, complicating a metacarpal fracture and well responding to antibiotic treatment, was recorded. Three further infections resulted after neglected intraarticular fractures, all of which underwent arthrodesis. No rotational deformities were observed. There was no mechanical failure of the fixation in any case.

Conclusion: The fixation of metacarpal and phalangeal fractures using K-wires seems to be a useful method minimally invasive, stable and well tolerated by the patient, not interfering with the mobility of the joints. K-wires are easily removed and of low cost. The functional outcome of this method seems to be quite satisfactory.

The aim of this study is to evaluate the mid-term results of the Genesis I Total Knee prosthesis (asymmetric tibial component plateaus), retaining the posterior cruciate ligament and not resurfacing the patella in all patients.

Between 1992 and 1999, 90 patients (116 knees) were operated (81 women and 9 men) of an average age of 68 (52–82) years. The indication for the operation was osteoarthritis. 84 patients (109 knees) were evaluated clinically and roentgenographically (Knee Society Knee Score). The average follow-up time was 74.1 (29.6–113.7) months.

There were no cases of infections. Three of the patients required a second operation. Two of them had their patellae replaced (1,5 and 3 years postoperatively) due to persisting patellofemoral pain. In a third patient the knee was revised due to excessive wear of the polyethylene component five years postoperatively. Moreover, major polyethylene wear was also observed six years postopertively on another patient, asymptomatic and unwilling to undergo a revision. The clinical results were satisfactory with a mean Knee Score of 97 (74–100) and a Function Score of 80 (5–100). The mean range of motion was 113° (85°–135°). There was no evidence of loosening or any radiolucent line found radiographically.

We consider the results of the Genesis I Total Knee Arthroplasty satisfactory. The asymmetric shape of the tibial condyles ensures the fitting of the tibial component. Even in cases of severe patella damage, we believe that replacement of the patella is not required. Occurrence of patellofemoral problems can be usually attributed to mal-tracking of the patella or to component malposisioning.