The classic microsurgical technique was executed at 149 patients. (A three-centimeter longitudinal incision, which was never extended beyond the distal crease of wrist. At twenty-one patients, the double-incision technique was performed [a small transverse incision at the wrist’s distal crease, &
a short longitudinal incision five centimeters away from the distal crease of wrist). While in 20 patients we decompressed the C.T. from just one small transverse incision at the wrist’s distal crease. It was possible to follow up, with clinical findings and repeated EMS, only sixty of them. All operations were executed under local anesthesia and loupes were always used. The cases that we operated on are of medium and of advanced severity of chronic carpal tunnel syndrome, while, according to the neurologist, at least five cases were acute. The first follow-up was done on the 2nd or 3rd postoperative day. The patients’ positive assertions that numbness – tingling and nocturnal pain that used to jolt them awake at night were cured were of a great importance. After the sixth postoperative month, a new EMG study was performed, at the patient’s convenience. A questionnaire was given to the patient to answer.
Purpose of this study is to compare the two techniques, [sliding nail plate, or locking intramedullary nail type ã], and to estimate their results of the surgical treatment of the subtrochanteric fractures of the femur.
They were all surgically treated. In 8 cases we performed the 135 DHS nailing and in the 21 cases the 95 DCP nailing. In the remaining 9 fracture cases we performed intramedullary nail type ã nail. In some cases, (plaiting – surgery) we used allograft. There were no intrasurgical complications. Two material breakages, [failure], occurred as post-surgical complication [95 DCP), the one was treated with locking intramedullary nail type ã, and the other with prosthetic replacement [ Thomson]. The patients started moving immediately, although they used partial wait bearing in a period of 3 days to 6 weeks, depending on the type of fracture and internal fixation. The operation lasted from 3/4h up to 2h and we transfused from 1 to 3 blood units (mean 2,5).. Results were better with locking intramedullary nail, than with any type of plating, [biological advantages – less failure].
Infection occurred in 7 patients (10%) from 1 to 144 months (median 12 mo): in 6 patients prosthesis removal was needed to achieve healing. Mechanical complications were present in 19 patients (27%): 15 (21%) had prosthetic head instability (5 surgically treated), 2 breakage of the prosthetic stem and 2 prosthetic disassembly.