Aims: In this study we assessed the results of the hemi-arthroplasty for shoulder fractures in patients with a follow-up 2 to 7 years. Methods: Twenty six patients (20 women and 6 men, mean age 64.7±8.2 years [range 41 to 78 years]), with a fracture of the upper humerus requiring hemiarthroplasty, were followed-up 2–7 years after surgery. Ten Coþeld, nine Global and seven Aequalis prosthesis were implanted, all cemented. All the procedures were performed 0–17 days after the injury (mean 5.5±4.6 days). The clinical outcome was assessed using the Constant-Murley scale. Results: The mean score, at their last follow up, was 70.4±16.4% (39–96%). The mean ßexion of the arm was 150û (30û–175û), the mean abduction was 145û (30û–170û), the mean external rotation was 30û (10û–45û) and the internal rotation corresponded with a position of the dorsum of the hand at the L3 vertebrae. The patients in our series achieved the optimum clinical result during the þrst 6 months after the operation. No statistical signiþcant improvement occurred after this period. Six months after the injury 20 out of the 26 patients (76.9%) had the same activity level as they had prior to the fracture. At their last follow up eighteen patients (69.2%) had no any pain and 7 (27%) patients had some mild pain at the end of their daily activities and 1 patient (3.8%) had pain even with mild activities. Conclusions: Shoulder hemiarthroplasty seems to be a worthwhile procedure in modern orthopaedic surgeonsñ armamentarium, giving predictable results presuming careful selection of the patients, restoration of the individual anatomy of the shoulder and aggressive rehabilitation program during the þrst 6 months after surgery.

Aim: The purpose of this prospective study was to assess the functional outcome of conservative treatment with early ambulation of thoracolumbar burst spinal fractures, using the Load Shearing classification.

Material – Methods: From 1997 to 2001, 60 consecutive patients with single-level thoracolumbar spinal injury, with no neurological impairment, were classified according to the Load Shearing scoring and were managed non-operatively. A custom-made thoracolumbosacral orthosis was worn by all patients for six months, and early ambulation was recommended. Several radiological parameters were evaluated; the Denis Pain and Work Scale was used to assess the clinical outcome. The average follow-up period was 42 months (range, 24 to 55 months).

Results: During this period the spinal canal occupation was significantly reduced. Other radiological parameters, such as Cobb’s angle and anterior vertebral body compression, showed loss of fracture reduction, which was statistically insignificant. However, the functional outcome was satisfactory in 55 of 60 patients with no complications recorded on completion of treatment. Conclusions: Load Sharing scoring is a reliable and easy-to-use classification for the conservative treatment and prognosis of thoracolumbar spinal fractures. Because of the three characteristics of the fracture site this classification can also predict the structural results of the spinal injury, such as posttraumatic kyphosis, and thereby the functional outcome in conservatively treated patients.

Aim: The purpose of this prospective study was an evaluation of results in primary treatment of flexor tendon laceration in zone II. Special emphasis has been given to the postoperative rehabilitation program.

Material and Methods: Nineteen patients, (23 fingers), with laceration of the flexor tendons in zone II were treated operatively. Twelve males and seven females were included in the study. Their mean age was 28 (range, 16 to 50) years. In twelve cases a concomitant laceration of the digital nerve was present, hi all cases primary repair of all injured tendons and nerves was performed and a dorsal splint was applied. On third to fifth postoperative day an exercise program commenced involving passive flexion-active extension of the injured fingers. Eighteen (22 fingers) of 19 patients completed the follow-up.

Results: The results were estimated according to Strickland’s original classification system. In fifteen cases the result was excellent, in five good, and in two fair. Conclusions: After primary repair of injured flexor tendons, close follow-up, early protected motion and unrestricted motion of the interphalangeal joints affers the best chance of restoring optimal function to the hand.