Aim: The results of open tibial shaft fractures treated with reamed intramedullary nailing are presented. The same nail and protocol of treatent was used in all patients.

Patients and Methods: Twenty patients (mean age 25.2 years, s.d.: 6.0) with open tibial shaft fracture. The fractures were classified according to Gustillo classification (grade-I: 7, grade-II: 6, grade-IIIA: 7), and the comminution according to Winquist-Hansen classification (stable: 7, unstable: 13). All patients were treated within 6 hours from the injury, the wound was left open, followed by wound inspection and re-debridement (if needed) after 48 hours. A delayed primary suture or wound coverage was applied within 4–6 days.

Results: Eighteen fractures united with no need for additional operation. Non-union developed in 2 grade IIIA fractures (1 fracture healed after exchange nailing, and 1 fracture required an alternative method of treatment. The mean union time was 22.7 weeks (grade I: 20.2 weeks, grade II: 20.3 weeks, grade IIIA: 26.3 weeks). There was no infection. Dynamisation was applied in 7 fractures.

Conclusion: The results in this small series of open tibial shaft fractures treated with reamed intramedullary nailing are satisfactory and in accordance with the results of large larger-scale studies published (the recent years) recently in the literature.

Aim: The aim was to study the blood loss and the need for transfusion in patients with fracture of the upper end of the femur.

Patients – Methods: In a prospective study we included 50 patients with intertrochanteric fractures (Group 1) and patients with fractures of the femoral neck (Group 2). Patients with other concomitant injuries or fractures were excluded. The blood loss and the need for transfusion were studied using as lower limit for transfusion Hb 10 gr./dl.

Results: The average age of the patients was 80.2 years (s.d. 8.3). Patients of the Group 2 (mean 73, s.d. 10) were younger than patients in Group 1 (average 82, s.d. 5.6).

Two thirds of the patients were women, with higher proportion of women in Group 1 (women: 81.3%, men:18.7%) than in Group 2 (women: 66.7%, men:33.3%).

In Group 1 the average blood loss (3.4 units) as well as the average need for transfusion (1.9 units) was higher than in Croup 2 (average blood loss 2.8 units, average need for transfusion 1.6 units). The average Hb admission in Group 1 was 11.4 and in Group 2 was 11.8.

In patients that were operated on within the first 24 hours after the injury, the average blood loss was lower than in patients who were operated on later.

Conclusions: In patients with intertrochanteric fractures the blood loss as well as the need for transfusion was higher than in patients with femoral neck fractures. Early surgical treatment led to less blood loss.

Aim: The aim of this presentation is to present a new fixation device in ACL reconstruction using Hamstrings (Semitendonosous and Gracilis tendons) and the early clinical results.

Material – Methods: The new technique has been applied in ten patients.

Technique: Arthroscopic technique using a single skin incision. Four stand graft from the Semitendonosous and Gracilis tendons was used.

Femoral fixation: A Suspensory device -Endoflip- was used. Tibial fixation: A bioabsorbal screw -Bilok-was used. Postoperative regime: Early knee mobilization, partial weight bearing using crutches.

Results: The learning time for the femoral fixation was short. Second skin incision on the femoral site was necessary in the first two patients. There were no intraoperative or postoperative complications. The early clinical results are encouraging.

Conclusion: The early clinical results indicate that the above-mentioned technique is a reliable one for graft fixation in ACL reconstruction.