Background: Extra-articular distal tibial fractures make up approximately 15% of all distal tibia fractures (1, 2). The main cause for such fractures is axial and rotational forces on the lower extremity (3-5). According to the 2018 AO/OTA Fracture and Dislocation Classification, distal tibia fracture (43A-C class) is defined as the fracture contained within a square with a height equal to the widest portion of the tibial epiphysis, which usually includes fractures within approximately 4 cm of the tibial plafond (6-8). . .

Background: Intramedullary interlocking nailing has emerged as one of the suitable management options for distal tibia fractures as it allows mechanical compression on weight-bearing, which stimulates Bone healing. We studied 40 cases of extra-articular distal tibia fracture treated by intramedullary nailing. Methods: We retrospectively studied 40 patients of both sexes above the age of 18 years with closed fractures and grade 1, 2, and 3A compound fractures treated at SVP Hospital, Ahmedabad, India. Clinically, the fracture was considered to be united when the patient was completely pain-free. Patients were followed up at monthly intervals till union. At each follow-up, patients were assessed both clinically and radiographically, and details were recorded based on proforma. Results: The evaluation of the result was done using American Orthopedic Foot and Ankle Society (AOFAS) criteria. Thirty-three patients had excellent functional results, five had good functional results, and Two had fair functional results. In this study, 38 (95%) patients had radiological union within 24 weeks. Two patients had union after 28 weeks. Conclusion: Intramedullary nailing is a minimally invasive procedure that preserves the soft tissue and the fracture hematoma. It maintains the length, alignment, and rotation and allows micromotion at the fracture site on weight-bearing, which stimulates callus formation. It has a good functional outcome with gratifying results when used in extra-articular distal tibia fractures.

Over the last several decades, implants have been used to treat fractures and promote healing. The most important reason for deformation and shortening of the Bone during healing due to loading on the Nails is a lack of strength of the intramedullary nail. Materials with very fine grain dimensions are considered for such purposes. Ultrafine-grained (UFG) materials have structural elements with very fine grain sizes. Several methods for producing UFG materials have been developed, one of which is the top-down approach, which refines coarse-grained metals via severe plastic deformation (SPD). The SPD technique has several advantages that set it apart from other methods of synthesizing. Two of the SPD methods used in this study were the repetitive corrugation and straightening (RCS) process and the equal channel angular pressing (ECAP) process on a 316L stainless steel rod. Mechanical tests were performed on the rods produced using these methods. Under loading, simulation results revealed that the Bone implanted by the RCS rod has greater structural stiffness than the Bone implanted by an ECAPed 316L stainless steel rod.

Background: The acromioclavicular joint dislocation is one of the most common joint injuries that despite different methods of repair in cases of dislocation of grade 3 to 6, there are still many conflicts regarding the efficacy of these methods in previous studies. Therefore, in this study, we aimed to evaluate the patients' recovery and function after the fixation of the acromioclavicular joint with grade 3-6 using two surgical methods including pin and screw tools. Methods: In this cross-sectional study, 34 patients with dislocation of acromioclavicular joint with grade 3 to 6 who were treated with pin (group 1) or screw (group 2) in two groups of 17 patients were studied. Satisfaction from surgery and functional recovery were assessed using the Shoulder score questionnaire. Results: Overall satisfaction rate was 88. 2% in the group 1 and 82. 4% in the group 2 (P>0. 05). There was no significant difference in the range of motion in different motions of the joint (p>0. 05). The score for the shoulder score questionnaire was 11. 23 in the first group and 11. 70 in the second group was, which did not show significant difference (P>0. 05). Conclusion: Surgical treatment using pin and screw tools in cases of acromioclavicular joint dislocation with grade 3-6 can achieve the same therapeutic and functional results. However, more studies are needed to confirm the efficacy of these two tools in various cases of acromioclavicular joint dislocation.

Backgrounds Various studies have been conducted on the local and systemic effects of orthopedic hardware. This study aimed to evaluate the pathologic reactions to orthopedic hardware (nail and plate) in patients. Methods In this descriptive study، the pathologic reactions of 15 patients (12 males and 3 females) with a mean age of 37. 41 years، who underwent orthopaedic hardware removal surgery in two Hospitals in Sari، Iran، were assessed through observation، laboratory tissue evaluation، and a questionnaire. Results In this research، no allergic reaction was observed in the patients after the insertion of hardware. In this regard، 6. 66% of patients reported infection after insertion of hardware، and there was one case of non: : union: : . Furthermore، no systematic complication was observed in any of the patients. The majority of patients had moderate tissue inflammation at the hardware site، and there was no evidence of malignancy in any of the pathology samples. Conclusion According to the results of the research، a moderate level of tissue inflammation might be observed at the site of orthopedic hardware placement.

Background: Femoral shaft fractures regularly occur after major trauma, such as road traffic accidents and falls from a height (1, 2). These fractures usually are associated with concurrent injuries due to the high-energy forces in the trauma (3). In addition, due to osteopenia, this type of fracture is also frequent in the elderly population (1, 4). The AO Foundation/Orthopedic Trauma Association (AO/OTA) has categorized femoral shaft fractures into three subtypes: A, B, and C,they represent the simple fracture, fractures with more than two fragments (with maintained continuity), and complicated with disjoined Bone cortex subsequently (5). . .

Background: Femoral shaft fractures in children are treated by a variety of methods such as traction, spica cast, plate, external fixator and Nails. In recent years Elastic Stable Intramedullary Nailing (ESIN) has became popular. This is a report of our experience with such a fixation system.Methods: During a 2-year period (2003-2005) 32 femoral shaft fractures in children between 5 to 10 years old were treated with ESIN. Demographic data, fracture and fixation characteristics and complications were studied with a 7-months average follow-up.Results: All 32 patients started ambulating one week after surgery, had an average 4 days of hospitalization, and had full weight-bearing ambulation in 6 weeks. All cases healed in 10 weeks-on average. Full knee motion returned in 8 weeks. Three cases had malunion either virus or valgus, misalignment or 1-2 centimeters of shortening. The most common complaint was pain around the nail insertion sites for the first two weeks.Conclusion: ESIN is valuable and dependable method for non-comminuted femoral shaft fracture fixation in 5-10 years old patients.  

Background: Femoral shaft fractures contribute to 1% of all fractures and 7% of femoral fractures (1, 2). It peaks in young men (median age = 27 years) due to mainly high-energy forces sustained in motor vehicle accidents and in older women (median age = 80 years) because of osteopenia (2-4). Because the femur is the longest and strongest Bone in the body (5, 6), mainly high-energy forces might cause femoral shaft fracture. Therefore, femoral shaft fractures commonly coincide with multiple concurrent trauma and other skeletal fractures or organ injuries (5, 6). The Arbeitsgemeinschaft fü, r Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) classification categorized this type of the fracture into three subtypes: type A represents simple fracture, type B shows fractures with more than two fragments, but the Bone continuity is maintained, and type C displays the complex fractures with the disjoined Bone cortex (2, 7). . .

Soil nailing is an in-situ soil reinforcement technique which has been used during the past two decades to retain excavations or stabilize slopes. In Europe, the French and German methods and in United States, the Davis method, are the design methods that have been most commonly used. These methods only control the global stability of the wall and pull out of the Nails. In this paper a design approach which provides a rational estimate of maximum tension and deflection of Nails is introduced. To evaluate these forces and deflections a user friendly computer code (soiln) has been written. Examples of applications of this program are provided and the results are compared with those obtained from other methods.

Onychogryphosis is a disorder caused by nail trauma. Although it may have an evolutionary cause, hitting and wearing tight shoes are significant factors. The patient was a 64-year-old man with a 20-year history of diabetes and coronary heart disease who presented to the wound clinic for a diabetic foot ulcer on his right foot. Onychogryphosis, also known as ram's horn nail, was diagnosed due to the high thickness, rotation, and downward twisting of the nail, resulting in a ram-like horn appearance. After disinfecting the fingers with an alcohol-free disinfectant spray, large and hard parts of the affected Nails were removed using Dual-action nail clippers, and sharp edges and deformations were smoothed and sharpened using a nail file machine. Substantial nail improvement was observed after the procedure. Based on the photos taken after the procedure, the patient's Nails were in good condition, and the patient was satisfied with the outcome. Appropriate foot health education was provided to the patient, and he was referred to an orthotics and prosthetics specialist to obtain suitable shoes.