The treatment of radius head comminuted fractures remains controversial. The radius head excision and the radius head arthroplasty have been proposed as the main treatment methods. We present 13 cases, 6 men and 7 women aged 25–68 years old with radius head comminuted fractures Mason type III during 2005–2006. Elbow dislocation was also present in 3 patients, ulnar comminuted fracture in 1 patient and ipsilateral cubitocarpal comminuted fracture in another patient. All patients were managed operatively with radius head removal and cementless monopolar metallic prothesis placement. The others musculoskeletal injuries were managed at the same time. The average hospitalization was 6.8 days without complication postoperatively. 12 cases were followed up and the average follow up period was 26 months. In 6 cases the results were excellent, in 3 cases the results were moderate and in 3 cases the results were bad. We believe that the arthroplasty is the acceptable method in radius head comminuted fractures management especially in cases were complicated elbow damages are present.
The efficacy and safety of hyaloyronic-acid in patients with osteoarthritis of the knee were investigated, in the present study. A total of 125 patients were included in the study during the last five years (1996–2001). Treatment was one weekly, intraarticular administration of 20-mg/2ml hyalouronic acid for 5 consecutive weeks. All the patients were clinically assessed before each injection and every three months after the end of the therapy. X-ray examinations were performed 6 months and one year after the end of therapy. All 125 patients complete the study. Spontaneous pain decreased during the treatment course and continued to decrease-up to the end of the study in patients with 1st and 2nd stage osteoarthritis of the knee. In these patients observed a substantial improvement of morning stiffness and supra-patellar circumference. In all patients there weren’t any x-ray improvement at the end of the therapy. The pain and joint stiffness were reapproranced in all patients after a mean time of five months after the end of the therapy. We didn’t observed any local or systemic adverse during the therapy. The results of this study demonstrate that intraarticular administration of hyalouronic-acid is safe and effective and confirms that the product is a valid alternative in the treatment of osteoarthritis of the knee.
Acromioclavicular joint dislocations (Grade 3) present challenging problems for the treating surgeon. We propose a retrospective radio clinical analysis of long-term outcome in a series of surgically treated patients to determine the long-term effects of the procedure on the acromioclavicular joint and possible implications for initial therapeutic decision. Twenty patients were reviewed at a mean 45, 5 months after surgery (range 8 – 85 months). Mean age at surgery was 45, 8 years. All had an Allmon grade 3 acromioclavicular dislocation. All had early surgery for open reduction of acromioclavicular dislocation and temporary stabilization with two parallel transacromioclavicular pins and a wire (tension band). Two patients had a postoperative complication: one wound dehiscence and one fracture of the wire. The subjective outcome was in 12 patients. In one patient we had redislocation and in two patients we had joint stiffnes. Radiographically there were 4 cases with acromioclavicular osteoarthritis and there were coracoclavicular ossification in all patients. Surgical repair of grade 3 acromioclavicular dislocation by transacromioclavicular pinning without ligament suture, gave in this series satisfactory functional and subjective results that remained stable over time.
