The use of locking intramedullary nails in the treatment of long bone fractures is common. We present our preliminary work in the use of inflatable self-locking intramedullary nails for the treatment of long bone fractures. Twenty one patients were included in this work: 13 males and 8 females. The mean age was 25 years (range (18 to 42 years)). There were 8 tibial, seven femoral, and six humeral fractures. The mean operation time was 40.5 minutes for the humeral fractures (range 30 to 170 minutes), 30 minutes for the tibial fractures (range 20–90 minutes), and 60 minutes (range 30–170 minutes) for the femoral fractures. The radiation exposure time was 0.22 minutes for the tibial fixation, 0.28 minutes for the humeral and 0.44 minutes for the femoral fractures. The mean follow-up period was 49 weeks (range 6 to 60 weeks).

Stable fixation with no axial deviation or displacement of the fracture fragments was seen in all cases. Patients could partially weight bear on the 2nd day after surgery. No post-operative complications were noted.

From this preliminary work we conclude that the use of the inflatable self-locking intramedullary nails in the treatment of long bone fractures is simple, quick and stable. This procedure does not need intramedullary reaming that may jeopardise the medullary canal vessels. The surgical as well as the radiation time required for fixation were reduced.

Metallosis after a total joint arthroplasty, although uncommon, is a serious complication that may occur. The deposition of metallic wear debris in the joint space may lead to thickening of the synovium and the formation of a thin dark colored film substance. We present 4 cases of metallosis from a total number of 246 total knee arthroplasties that were performed the last 10 years in our department. All patients were females with a mean age of 71.5 years (range 67 to77 years). The main symptoms were pain, swelling, and limited range of motion around the knee joint space. No signs of sinuses or wound drainage were noted. Bone scanning showed increased activity around the prosthesis. Needle joint aspiration and intra-operative wound culture were negative for any microorganism growth. Patients have had 4 types of different implants; AGC, S+G, Kirschner and Rotaglide. Extensive synovectomy and revision of all the implants were done on 3 patients and only the revision of the polyethylene component was done on one patient.

We conclude that metallosis is a serious complication that requires surgical treatment. Different diagnostic tests should be also included in order to exclude the possibility of infection. Proper alignment of the implants combined with proper soft tissue balance are 2 important factors to be respected when performing TKA.