Introduction and purpose: Achilles tendon tears with a surgical indication can be approached by means of either a standard open surgery or an alternative technique, namely a percutaneous suture of the tendon rupture. This study compares the functional results and complications of both techniques in order to assess the differences between them. The purpose of the paper is to determine whether percutaneous sutures are a valid option for the treatment of these kinds of lesions.

Materials and methods: A prospective randomized study was carried out of two groups of patients. One included 26 patients where the Achilles tendon tear was repaired by means of a percutaneous suture; the other was a control group where the classical open surgery technique was used. The mean patient age was 41 years. 92% were male. 54% of lesions were on the left side. A comparison was made of functional results and of the complications which appeared in both groups.

Results: Both groups were homogeneous regarding age, laterality and relevant antecedents. Functional results and the complications’ rate were similar in both groups.

Conclusions: Although the percutaneous suture is not a widespread technique, the study shows it as a valid alternative for the treatment of Achilles tendon ruptures since it leads to a level of function similar to that of open surgery.

Aims: The treatment of proximal humeral fracture is controversial. We proposed a syntesis with a solid nail system in order to achieve a good functional recovery Material and methods: Prospective study of 12 patients, mean age of 51 years (33 y–85y), since 2000 – 2002. All alleatory included according surgeon assignation. The men/women: 6/6. The right/left side 5/7.

Follow up period: 8 month (6m–15m).

Associated pathology: 1 ipsilateral linfedema and 1 TCE, (politrauma) X-Ray evaluation: P.A., axilary and lateral scapular view. CT scan was made to evaluate fracture patterns.

Neer classification: 6: 3-Neer; 5: 4-Neer and 1: 2-Neer part non union fracture.

Polarus nail were used in all. All (except 2)start functional recovery in first postoperative day. Constant test and x-Ray were made at regulars period.

Results: All consolidated: mean 5 weeks (5–11 w) without residual mal union. In two: nail with little proximal procidence without repercussion. In 1 was necessary the extraction of one screw All recovery its functional range of movement after 3 month. Two: limited range of movement, both have returned to habitual home activities. The Constant test was improving, mean of 74% (54–94%) Conclusions: The Polarus nail is an excellent synthesis for these fractures: it’s minimally invasive, gives a solid synthesis without hardware failures and facilitates an early rehabilitation program.

Introduction and Objectives: Non-unions of long bones represents a challenge for the orthopaedic surgeon due to the difficulty of treatment and high use of resources (human, surgical, etc.) which certainly raises health care costs. The development of morphogenetic proteins for the treatment of this clinical condition provides a powerful means of achieving the desired result: consolidation of the non-union.

Materials and Methods: From June 2002 to May 2003, we treated 5 cases of non-union of long bones (2 of the humerus, 1 femur, 1 tibia, and one knee arthrodesis). The group included 3 males and one female, ranging in age from 23 to 71 years (mean 47.2 years). Three of the subjects had previously undergone surgery between 1 and 7 times. One case presented with a bone defect in the distal third of the humerus. All cases were treated using mechanical stabilisation of the fracture. In one case, a bone bank graft was used, and in another, an autologous graft was used.

Results: Bone healing was achieved in all cases, except in one humerus.

Discussion and Conclusions: BMP-7 (OP-1) appears to be an advance in the treatment of long bone non-unions. Though it does not eliminate the need for adequate surgical treatment of non-unions (resection of the focus, exposure until bleeding bone, and mechanical stabilisation), this method does favor osteogenesis at the fracture site and avoids the morbidity associated with extraction of autologous bone from the iliac crest.