PURPOSE: To compare the functionnal and radiological results concerning the “same” distal radius fracture of 3 different and consecutive procedure : dorsal plate, pins and palmar plate.

MATERIAL AND METHOD: Sixty two patients with a dorsally displaced extra-articular fracture of the distal radius were treated by dorsal plating [group 1, 20 patients, mean age 59,9 yo (25–87)], pinning [group 2, (22 patients, mean age 55,6 yo (17–83)] and volar plating [group 3, 20 patients mean age 57,1 yo (17–78)]. Patients were evaluated by a surgeon not involved in the treatment. Posttreatment evaluations consisted of measurements of range of motion, grip strength, radiographic evaluations between post operative time and last follow up, and evaluation by Herzberg scoring, associated with Gartland and Werley rating system and completion of Disability of Arm, Shoulder, and Hand questionnaires. Comparaison of three groups was performed with Kruskall-Wallis or ANOVA test (quantitatives variables) and Khi-2 (qualitatives variables) (p-value < 0.05).

RESULTS : Operative time was same for plate groups but two times more than pin groups. In Group 1 most complications and fair functionnal results were reported (32%) in spite highest follow up. Group 3 showed best results in flexion-extension, with DASH scoring, ulnar variance conservation, and most excellent and good results with Gartland and werley rating system. In group 2 and 3 same percentage of complications were pointed: 5%. Indenpendtly of tretament best results were reported in men, less than 30 yo.

DISCUSSION : If dorsal plate remains logical, such a fixation is challenging with high percentage of complications. In such extrarticular distal radius fracture palmar plate as pinning reach good and reliable functionnal results. Reduction of the palmar cortex remains probably the technical point. If the palmar plate is sufficiently rigid it can offer adequate stability for the treatment of the distal radius fracture in which the anterior and/or posterior metaphyseal cortex is frequently comminuted severely.

Introduction: Conventional total hip replacement has a high rate of failure in young or high demand patients due to polyethylene wear, therefore, we perform a metal on metal hip resurfacing in these patients. Materials and Methods: The cup is all chrome cobalt alloy, with HA coating and the beads of the porous ingrowth surface are integrated with the substrate metal. The metal head is þxed with low viscosity cement, after careful precise preparation of femoral head.33 hybrid hip resurfacing in 29 patients. Average age was 42.8 years. Results: Harris Hip Score: 34.2 points average preoperatively and 97.1 points at the last examination. The average follow-up was 14.7 month. Discussion: The advantages: Minimal bone resection which makes for easier future revision, normal proximal femoral loading that hence avoidance of the stress shielding present in standard hip replacements, less risk of dislocation with greater range of motion, the physiological biomechanics of the joint is maintained, proprioception is maintained and we have noted that the postoperative recovery is extremely smooth and quick.

The disadvantages: Leg length and neck version cannot be altered. Hip resurfacing is, technically, a demanding procedure.

Contraindications: osteoporosis, varus neck.

Conclusions: Our early results are encouraging. We believe that metal on metal hybrid resurfacing is a legitimate alternative for active patients who require hip arthroplasty.