The authors evidences the results of their experience, matured in the Orthopaedic and Traumatologic Division, of Fano Hospital, that have been involved 106 patients with lateral femoral fractures from the January 2003 to 31st July 2004, treated with endomedullary nailing (Endovis). With a medium follow up of 12 months, 89 patients have been estimated clinically and radiologically, classified second to AO-Muller: 31A1 (21%), 31A2 (46%), 31A3 (33%).For all the patients we have used the classification of operative risk ASA: ASA 1–2 (88.5%), ASA 3–4 (14%), ASA 4 (2.5%).In agreement with the literature, the 88%, of the patients have been subordinate to surgical intervention within 48 hours, from the admission, while for serious patients with severe pathology, the treatment has been done within the 72 hours. In only 3 patients (1%) the surgical intervention was complicated with break down of the screw; in 8 cases (7.5%) an iper-correction in valgus position.

As the importance from socioeconomic point of such pathology, we think that the Endovis nail, is a valid method of osteosynthesis and it guarantees an early mobilization, reduced hospitalisations with obvious positive reply on the cost/benefit ratio.

Many surgical techniques based on a distal osteotomy are used for the treatment of the symptomatic hallux valgus. We review the results of percutaneous distal osteotomy retrospectively.

Between 1998 and 2003, 52 patients were operated on using a distal osteotomy for symptomatic hallux valgus. We investigated 35 females and nine males for a mean follow-up time of 4.6 years. We performed a percutaneous distal osteotomy (PDO) with a 2-mm Kirschner wire. Radiological analysis consisted of measuring the hallux valgus angle (HV) and the angle between the first and the second metatarsal (M). Clinical evaluation was performed with the AOFAS scale.

Good bony contact was achieved and all the osteotomies united and no aseptic necrosis was found. According to the questionnaire, the pre-operative AOFAS score was 44.3 and 92.5 at the follow-up examination. Radiological analysis showed that the pre-operative HV angle was 13.7° and 9.8° at follow-up. The pre-operative M angle was 24.1° and 13.6° at follow-up.

The PDO technique gives good results at a mean follow-up of 4.6 years. The positive aspects of this technique are: short surgical time, low incidence of complications and high patient compliance. A single 2-mm Kirschner wire is enough to achieve adequate stabilisation of the osteotomy, is less expensive than other surgical instruments for hallux valgus and is very easy to remove.