To assess the outcome of Wilson’s osteotomy of the first metatarsal to correct Hallux Valgus.

Two hundred and forty feet in 172 patients who had surgery for pain were reviewed clinically and radiologically. Age ranged from 28 to 82 years (mean 55 years) and duration of follow-up ranged from 2 to 15 years (mean 6 years). A mini external fixation was used to stabilize the osteotomy.

The average AOFAS score improved from 51.6 to 89.5 points at the last follow-up. In 96% of the cases, the final outcome was satisfactory as far symptomatic improvement was concerned. A 4% only was dissatisfied with the outcome of the surgery due to metatar-salgia, restricted first metatarsophalangeal joint motion or lack of correction. There were no cases of avascular necrosis of the metatarsal head. We had five cases of delayed union but they didn’t need further surgery.

The average preoperative HVA and IMA were 34.80 (range: 180–540) and 15.10 (range: 100–290), while the average postoperative HVA and IMA were 16.10 (range: 70–280) and 7.20 (range: 30–90) respectively.

Wilson’s osteotomy as a method of treatment of Hallux Valgus is technically straightforward, effective and with a predictable outcome. We believe that the external fixation offered increased stability at the osteotomy site and could be the reason why patients had a very low incidence of postoperative metatarsalgia and returned to their normal activities faster, thus giving a higher satisfaction rate.

Purpose: This study was performed to evaluate the results of intramedullary nailing of distal tibial fractures located within 5 cm of the ankle joint.

Materials and Method: From 1990 to 2007, 142 tibial fractures that involved the distal 5 cm of the tibia were treated with reamed intramedullary nailing with use of either two or three distal interlocking screws. Twenty-one tibial fractures were open and were treated primarily with external fixation and then with intramedullary nailing.

Seventy patients (49%) were under 20 years old, 85 (59%) were men and traffic accident was the main cause of fracture in 58 (41%) patients.

108 patients were treated with GK nail, 14 patients with modified GK nail and 20 patients with S2 nail.

All patients were allowed postoperatively full weight bearing with crutches till the fracture healing. Patients were evaluated clinically and radiographs were reviewed every three weeks till fracture healing. Last follow-up was at two years postoperatively.

The functional results were evaluated with the Iowa Ankle-Evaluating System.

Results: Acceptable radiographic alignment, defined as < 5° of angulation in any plane, was obtained in 135 patients (95%). No patient had any change in alignment between the immediate postoperative and the final radiographic evaluation. We had no non-unions or failures of the implant.

Complications included one superficial infection at the entry point of the nail and one iatrogenic fracture at the time of the intramedullary nailing. The fractures united at an average of 12.5 weeks.

The functional outcome was determined at one and two years postoperatively.

There was improvement in the Iowa Ankle-Evaluating System scores with time.

Conclusion: Intramedullary nailing is an effective alternative for the treatment of distal metaphyseal tibial fractures. Simple articular extension of the fracture is not a contraindication to intramedullary fixation. Functional outcomes improve with time.

Aim of the study : The purpose of this work was to study the short term results of the surgical treatment of subtrochanteric femoral fractures with the use of long gamma nail.

Material – method : Fifteen consecutive patients suffering from subtrochanteric fracture of their femur, were treated by means of long gamma nail in our clinic during the last two years. The type of fracture concluded comminuted subtrochanteric fractures, unstable spiral fractures and fractures on previous operated on peritrochanteric fractures.

Results : The patient’s age averaged the 76 years. There were 4 men and 11 women. The follow-up period was from 5 months to 2 years. The blood transfusion averaged the 2 units. All patients ambulated the second postoperative day and the fracture healing observed two months later. We have no infection, pseudarthrosis or hardware failure at this series.

Conclusion : Long gamma nail is a method of choice in the treatment of subtrochanteric femoral fractures. We can achieve stable osteosynthesis, without soft tissue damage and immediate ambulating of the patient.