Purpose: To present/evaluate the results of ‘intramedullary hip screw’ (IMHS) for treatment of subtrochanteric fractures of the hip.

Materials and Methods: Between 2003–2005 fifty four (54) patients aged 62–92 years old (average: 77,3 yrs) with subtrochanteric fractures of the hip were treated in our department with intramedullary hip screw (IMHS). Thirty one (31) patients were women and twenty three (23) were men. Thirty (30) fractures were located in the right hip and the remaining twenty four (24) in the left one. All patients were operated by the same surgical team –within 3 days from injury in the 86% of the cases. The duration of the procedure was between 55–75 minutes. Post-op, the patients were mobilized early with -at least–partial weight bearing and they were followed-up -clinically and radiologicallly for 7–30 months.

Results: 85% of the fractures were united within 14 weeks uneventfully. In seven cases, bone grafts were used. Three (3) cases of superficial wound inflammation and two case of haematoma were noticed. All above cases were treated successfully. Neither femur’s fractures (near or distal to the tip of IMHS) nor failure of implants were noticed. The 75% of patients achieved the pre-op status of rehabilitation.

Conclusions: The results of this study show that ‘intramedullary hip screw’ (IMHS) seems to be a reliable treatment for the subtrochanteric fractures of the hip; and it could be considered as one of treatment of choice for them.

Purpose: Description of the types of injuries occurring in ‘’semi-professional’’ soccer players, analysis some factors influencing the occurrence and registration of treatment’s options.

Material & Method: Between 1999–2003, 112 males semi-professional soccer players of different levels of skill, aged 16–38 (average: 28,4yrs) sustained 128 injuries during games or practice. Previous injuries, frequency of playing soccer weekly and options of treatment were also registered.

Results: 89% of injuries caused by trauma and 11% by overuse. 68% of injuries involved the lower extremity, 21% the upper extremity, 7% both upper & lower extremity and 4% the spine. Joints sprains predominated (36%), followed by fractures (25%), menisci tears (12%), ligaments injuries (10%), e.t.c. More than 15 different injuries were treated. Injuries to the ankle were most prevalent (42%), followed by the knee (26%) and the wrist (17%). The 2/3 of the injured players were playing soccer ‘’occasionally’’ (no more than 1–2 times per week, usually without any previous training), while the 1/3 had suffered previous injury in the same area of their body. 45% of injured players were > 30yrs old. Most injuries occurred during games. The treatment was surgically or conservatively (in ratio 1:1), depending on the type of injury.

Conclusions: Soccer players sustained a variety of injuries. Poor physical condition (occasionally playing & practicing), and ‘’personal’’ factors (previous injuries, level of skill) seemed to be related with the frequency and the severity of the occurred injuries. The treatment is based on the type of injury.

Purpose: The evaluation of the results of intramedullary nailing of open fractures of tibial shaft, which have been initially treated with external fixation.

Material & Method: Between 1997–2003, in 58 open fractures of tibial shaft (Gustillo type II & IIIa), the initially applied external fixation was replaced by an intramedullary nail type Russell-Taylor or Grosse-Kempf, either due to delay in union progress or due to frame‘s loosening. The conversion of external fixation to intramedullary nail was performed between 12th–15th week (average: 14th week), in two stages (1st stage: removal of EX.FIX, 2nd stage: insertion of I..N); with 13–22 days interval between the stages. In all cases, no elements of infection were noticed. In 45% of the patients bone grafting was performed at the time of nail‘s insertion. 37 patients were men and 21 were women, aged 19–52 years old (average: 31,7yrs). All patients were treated by the same surgical team and followed-up routinely.

Results: Union was achieved in 85% of the fractures, usually between 16–23 weeks (average: 18,7 weeks) from nail‘s insertion. In 7 cases, another operation was needed. Bone grafting in five, exchange of nail in two. Neither infection nor DVT was noticed. 82% of patients started sociallizing within 4 weeks, while 79% returned to pre-injury activities.

Conclusions: In cases that the union progress of the externally fixed open fractures of tibial shaft is not satisfactory; the conversion of external fixation to intramedullary nail seems to be a reliable option. The key points for the success of the method are timing and conditions of that conversion.