Aims: To present the experience of our department in the treatment of the closed shaft tibial fractures using the unreamed nail of Orthoþx. Material- Method: Between 1991–2001 we treated 180 closed fractures. There were162 men and 18 women. The preferred method of stabilization is unreamed nailing. Results: The average follow-up was 38 months. 165 of the fractures that were treated with uiin, healed in the proper time (3–6 months). The rest of them did not have callus signs and we revised the nailing using reamed nails. No screws and nail failure was observed. Three deep venous thrombosis, healed with no further complications. 65% of our patients were able to return to their usual activities within 4 months and the rest between 4–8 months. 15 non-unions and 2 malunions occurred and were treated with correction and reamed interlocking nailing. P.W.B. allowed for fractures type A and B according AO classiþcation from the beginning. F.W.B. allowed at mean 3 months. Conclusions: Immediate stabilization of the close fractures of the tibia using uiin (Orthoþx device): advances the healing of the fractures, decreases hospitalization time, helps early return to social activities, is easier for the surgeon, easier to place the distal locking screws, requires less operative time and less radiation. We did not þnd this method inferior to reamed interlocking nailing.

Aims: The purpose of our study is to present pitfalls and complications of intramedullary nailing in the treatment of femoral fractures and to examine their effect in bone healing. Methods: 180 patiens, suffering a femoral fracture, underwent primary intramedullary nailing and were followed up from 1996 to 2000 in our clinic (mean 16 months). 163 were men and 17 were women with a mean age 28 years. Four types of implants were used including AO, R-T, GK reamed nails and AO-PFN in 15 patiens who suffered also a unilateral intertrochanteric fracture. Results: Almost all fractures (98%) healed successfully. Insigniþcant complications and pitfalls happened in 20% of patients but did not inhibit bone healing. They concerned predominantly the size of the nail, the entry point, the valgus of varus insertion of the wire guide and the position of nail and screws. Serious complications were: one case with ARDS, one with fat embolism, 3 non-unions, 7 malunions, 2 with positive Trendelenburg sign and 15 cases with knee joint stiffness. Conclusions: Pitfalls and complications during intramedullary nailing procedure for the surgical treatment of femoral fractures do happen. Usually they are of less technical importance and have no effect in bone healling.