Since its creation, labral repair has become the preferred method among surgeons for the arthroscopic treatment of acetabular labral tears resulting in pain and dysfunction for patients. Labral reconstruction is performed mainly in revision hip arthroscopy but can be used in the primary setting when the labrum cannot be repaired or is calcified. The purpose of this study was to compare the survival between primary labral repair and labral reconstruction with survival defined as no further surgery (revision or total hip replacement).

Patients who underwent labral repair or reconstruction between January 2005 and December 2018 in the primary setting were included in the study. Patients were included if they had primary hip arthroscopy with the senior author for femoroacetabular impingement (FAI), involving either labral reconstruction or labral repair, and were within the ages of 18 and 65 at the time of surgery. Exclusion criteria included confounding injuries (Leggs Calves Perthes, avascular necrosis, femoral head fracture, etc.), history of unilateral or bilateral hip surgeries, or Tönnis grades of 2 or 3 at the time of surgery. Labral repairs were performed when adequate tissue was available for repair and labral reconstruction was performed when tissue was absent, ossified or torn beyond repair.

A total of 501 labral repairs and 114 labral reconstructions performed in the primary setting were included in the study. Labral reconstruction patients were older (37±10) compared to labral repair (34±11).(p=0.021). Second surgeries were required in 19/114 (17%) of labral reconstruction and 40/501(8%) [odds ratio: 2.3; 95% CI 1.3 to 4.2] (p=0.008). Revision hip arthroscopy were required in 6/114(5%) labral reconstructions and 33/501(6.5%) labral repair (p=0.496). Total hip replacement was required in 13/114 labral reconstructions and 7/501 labral repairs [odds ratio:9.1 95%CI 3.5 to 23] (p=< 0.01). The mean survival for the labral repair group was 10.2 years (95%CI:10 to 10.5) and 11.9 years (98%CI:10.9 to 12.8) in the labral reconstruction group.

Conversion to total hip was required more often following primary labral reconstruction. Revision hip arthroscopy rates were similar between groups as was the mean survival, with both over 10 years. Similar survival was seen in labral repair and reconstruction when strict patient selection criteria are followed.

We studied the treatment with osteosynthesis in the 23-C fractures. Material and methods: we reviewed 259 complete articular fractures of the distal radius, type 23-C treated with plate osteosynthesis during 10 years. All cases are documented with the AOI sheets. All cases were classiþed with the Classiþcation of long bones of M.E.MŸller. Results: in the 259 fractures, 137 are females and 122 males, the age are between 10 to 84 years, the age average are 48ñ59 years (60ñ52 in females group, and 35ñ19 in the males group).

105 (41%) cases are in the right wrist, and 154 (59%) cases in the left wrist, 32 (12%) are open fractures. Etiology: 9% work,36% Trafþc,11% Sports,27% Home, 17% Others. The 17% had pathological antecedents previously. 18ñ5% had local injuries associated and 24ñ3% had general injuries associated. The 85% were operated for a Senior surgeon, 53% with loco-regional anaesthesia; 50% were treated with antithrombotic prophilaxis, and 26% with antibiotic treatment. 40% of cases needed some additional implant and the 24% needed surgery for the collateral injuries. We had 2% of acute local complications and 1% of general acute complications. During the follow-up, the 10% had local late complications and 1% had general late complications.

At the end of the follow-up, in 92% of patients (234 cases) use the extremity better than 75%, and 89% were pain free. X-Ray evaluation: 2% were Distrophy, and in 33% of cases had some articular alteration. Four months post-operative the 59% were recovered. The þnal disability is < 25% in the 85% of cases. Final evaluation: 88% of cases are good or excellent.

We studied the effectiveness of treatment with AO-Mini external þxator in complete articular fractures of distal radius, type 23-C. Mat. and meth.: we were reviued 474 distal radius complete articular fractures treated with AO-Mini external þxator during 10 years. All of fractures were documented by de AOI sheets. We used de Classiþcation of long bones from M.E.MŸller because itñs a global system of classiþcation. Results: in 474 fractures, 246 are females and 228 males. The age are between 15 to 94 years, and the age average 51ñ59 years (63ñ14 females, 38ñ84 males).212 fractures are located in the right wrist, and 262 in the left wrist. 14% (66 cases) were open fractures. Etiology: 19% Work,23% Trafþc,8% Sports,30% Home, 20% Others. The 15% of cases had pathological antecedents previously, 27% had local injuries associated and 28% had general injuries associated. 68% were operated for a Senior Surgeon, 61% with loco-regional anaesthesia, 33% were treated with antithrombotic prophilaxis, and 25% with antibiotic treatment. The 46% of cases needed some other implant, and 15% needed surgery for collateral injuries. Complications: 4% local acute complications and 1% of general acute complications. In the late follow-up, 18% of cases were local late complications and 2% general late complications.

At the end of the follow-up, in 81% of cases the use of extremity was better than 75%, and 83% of patients were pain free.

X-Ray: 10% had Distrophy, and 56% had some articular alterations.

Four month post-operative, 54% were recovered, and at the end of the follow-up 68%, of cases the þnal disability is < 25%. The final evaluation: is good/excellent in the 75% of cases.