To evaluate our results of treatment of kyphosis following osteoporotic fractures of the last 3 years.

28 women with a mean age of 63,2 years were treated for a painful kyphotic deformity of a mean Cobb angle 76,1°. They all had posterior fusion with pedicular screws and rods enhanced with autologous bone graft as well as allografts. Cement augmentation was used in a number of screws. A cell saver for auto transfusion and continuous neurophysiological monitoring was used intraoperatively in all cases. All patients fitted with a thoracolumbar brace for 3 months.

The postoperative mean Cobb angle was 45,2° (40,6% improvement). Pain questionnaires at a mean postoperative follow up of 16 months showed excellent results in 10 patients (35,71%), good in 8 patients (28,57%), satisfactory in 6 patients (21,42%) and poor results in 4 patients (14,28%). All patients were satisfied with the cosmetic result. 2 patients presented a postoperative infection that was treated with debridement and antibiotics.

Kyphotic deformity following osteoporotic fractures may treated satisfactory with rods and pedicular screws with cement augmentation

The documentation of the results of combined anterior -posterior approach in the treatment of spinal tumors in our department.

A total of 28 patients (16 men – 12 women) aged 15 to 75 year old (mean age = 54 years) were treated. Of those 7 presented with a benign primary tumor and 21 with malignancies of which 15 were metastatic. 16 patients had a neurologic deficit but met the international criteria for surgical intervention. The staging of the tumors and their postoperative care was undertaken by a tumor centre. All patients underwent posterior decompression with laminectomy, resection of all posterior elements including part of the pedicle, excision of the tumor and posterior stabilization. This was followed at the same operative session by an anterior approach (transthoracic, transperitoneal or anterior cervical) corpectomy of the affected vertebrae and implantation of interbody cages secured with an anterior plate and screws in the healthy vertebrae.

7 patients improved neurologically following the operation while 9 had no change of their clinical condition. Perioperative complications were recorded in 5 patients. In 3 cases a dural tear was dealt with direct closure and 3 infections had to have surgical debridement at another stage and antimicrobial therapy.

The treatment of spinal tumors with combined anterior-posterior approach in one session for a radical excision of the tumor is a demanding procedure

Introduction: The operative treatment of intra- and supracondylar fractures presents a challenging problem for the orthopaedic surgeon, since their morphology may jeopardize fracture ‘s stability and patients’ early mobilization. The use of retrograde inserted intramedullary femoral nails seems to be offering solutions to these problems.

Material-methods: 13 patients have been included in the study, 11 females and 2 male. The mean age was 49.4 years (range 23 to 82). There was no open fracture and the injury had resulted mainly in long, oblique supracondylar fractures, with the exception of one case where an intracondylar component of the fracture was present combined with a fractured patella. Surgical intervention was performed within 5–12 days post-injury, for that reason all patient required a form of open reduction. Long nail fixation without proximal screw locking was performed in 3 cases. Plaster splint immobilization for 6 weeks was applied in two cases, the one with the intracondylar component and fractured patella and the more aged patient who suffered from dementia. Early mobilization was instructed in all other patients with progressive weight load bearing in correlation to the radiological appearance of fracture healing.

Results: Fracture healing was obtained in all cases within the expected time period, varying from 18 to 38 weeks No infections or VTE was noted. Patients’ mobilization had been early (dictated by patients’ collaboration and/or presence of coexisting injuries). Adverse reactions include quadriceps muscle wasting combined with some degree of extension lag (50% of cases). No adverse events related to the use of long nails without proximal screw locking have yet been detected.

Conclusion: Intramedullary retrograde nail fixation in supra- and intracondylar fractures of the lower end of the femur seems to be a relatively simple operative procedure, inducing functional outcome and patients satisfaction. Delayed callus formation and muscular wasting that was noted in some patients can be attributed to the open reduction technique.