Background: Clavicle Fracture, especially midshaft Fractures is a common bone injury that happens after a fall onto the shoulder. It is uncommon to need surgical treatment. We would like to report on a selected group of cases that required open reduction and plate fixation.Methods: 53 consecutive adult patients with severely displaced fresh Fractures of the middle third of the clavicle, who were treated by open reduction and plate internal fixation, were studied in a one year period in Zahedan, Iran. Union shoulder motion and complications were analyzed in 49 patients (29 women, 20 men) who referred for follow-up, with an average follow-up of 12 months.Results: The mean age of patients was 33.4 years (19-62 years). 48 cases (97.9%) obtained union and one case (2%) developed malunion and required corrective osteotomy. Dermatologic complications were observed in 2 cases. All the patients had full motion and function.Conclusion: Open reduction and plate fixation of severely displacement fresh clavicle Fracture in well-selected cases can result into good union with minimal complications rate.

Background: Clavicle is a common bone to Fracture, and is most often treated with nonsurgical methods. Surgery may become indicated in occasional case of irreducible Fracture with considerable displacement, open Fracture, floating shoulder, and associated neurovascular injury, nonunion. There is still uncertainty about the best surgical method for this condition. In this study, we evaluated the results for intra-medullary screw fixation of clavicle Fracture.Methods: In a prospective study between March 2005 and March 2007, 20 clavicular Fracture (13 males, 7 females) with mean age of 32 years old (20-55), that had indication for surgery, were fixed with intra-medulary cannulated screw through a mini incision. We evaluated time to union, shoulder range of motion, side effects and patient satisfaction with a mean follow-up of 6 months (4-10 months).Results: The mean time to union was 10 weeks. The union was uncomplicated in 19 (95%) patients, while 1 case (5%), the bending of cannulated screw after a new trauma, required replacement by a thicker screw. There was no significant complication after surgery. All the patients were satisfied with the surgery.Conclusions: Cannulated screw is an effective fixation method for the claviclular Fractures that are amenable to surgical treatment. Supplemental studies are necessary.

Background: The carpal structure consists of eight individual bones aligned in officially two rows, in axial plains, proximal and distal. The proximal row is made of three main bones and one sesamoid bone and from radial to ulnar includes scaphoid, lunate, triquetrum, and finally pisiform, which could be barely considered as an individual bone. This is because it has no articular surface attachment to proximal or distal bony structures, and is engulfed by flexor carpi ulnaris tendon. The distal row from radial side to ulnar side includes trapezium, trapezoid, capitate, and hamate. . .

Background: acetabular Fracture is the result of high energy trauma which if treated properly, would cause little morbidity but improper treatment of this Fracture might cause severe morbidity due to degenerative change in hip joint. This study considers short-term follow of acetabular Fracture fixation in a 2-year period in a training hospital.Methods: out of 59 cases of acetabular Fracture (50 males and 9 females with mean age of 34±7.4 years), 36 patients who had undergone open reduction and internal fixation filled the functional outcome form of western Ontario mcmaster (WOMAC). The follow-up time was 10-24 months.Results: the most common mechanism of injury was motor-vehicle accident and the most common Fracture type was posterior wall Fracture. The most common associated injury was distal metaphyseal Fracture of radius and in the upper extremity ipsilateral posterior hip dislocation in the lower extremities. Sciatic nerve injury due to primary trauma was seen in 6 cases, peroneal nerve injury after surgery in 2 patients. Wound infection cases (19.4%) with no limitation in motion. Functional assessment was done in 6 and 10 months post op by WOMAC score. The maximum value was seen in posterior wall Fracture and the minimum value in T type, trans+PW and PW+PC Fractures.Conclusions: short-term WOMAC scores suggest good outcome in surgical treatment of acetabular Fractures. A long-term follow up and correlation with radiographic reduction results is recommended.

Background: This study aimed to compare a new posteromedial approach with a conventional anteromedial approach to treat extra-articular distal tibia Fractures. Method: Thirty-two patients underwent distal tibia Fracture surgery. The patients were divided into two groups (anteromedial: n=17 and posteromedial: n=15) and followed for one year. Approaches were compared regarding their union time, American Orthopedics Foot and Ankle Society (AOFAS) score, and complications. Results: AOFAS score was 87. 3 ±,3. 1 and 88. 5 ±,2. 8 in anteromedial and posteromedial groups, respectively, and there was no statistically significant difference (P-value = 0. 282). The union time was 6. 1 ±,3. 8 months and 6. 4 ±,3. 1 months in the groups, which was not statistically significant (P-value = 0. 807). The prevalence of non-union and delayed union was not significantly different between the two groups (p-value = 0. 99). Conclusion: The modified posteromedial approach is a safe and feasible alternative surgical method for distal tibia extra-articular Fractures.

From 01.07.2002 to 30.12.730 Colles’ Fractures were treated in orthopedics/trauma unit of Rashid hospital, Dubai using different treatment modalities. Sixty of these Fractures were treated as unstable cases and were managed by closed reduction, percutaneous K-wire fixation and plaster immobilization. There were 7 females (11.7%, mean age 38.14) and 52 males (88.3% mean age 37.32). Thirty of the Fractures occurred on the right side and thirty on the left side (50% each). Thirty two of the Fractures happened by falling from height, and 15 from simple falling on outstretched hand when walking. Thirteen Fractures resulted from road accidents.The Fractures were studied and analyzed using Frykman’s and Universal classifications. Two to 5 K. wires (mean 2.63) were used for percutaneous fixation of the Fractures. Reductions were checked by measuring the radial angle, volar angle, dorsal angle, dorsal displacement, radial displacement, axial shortening and articular incongruity.Postoperatively 34 reductions and K. wire fixations were found in unacceptable positions (56.7%). Analysis of the Fractures in Frykman’s classification showed a significant relation of Frykman’s type 1 and 2 Fractures with acceptable results (P=0.037 and P=0.028 respectively). Also type II Universal classification showed a significant relation to acceptable results (P=0.003) but other types of Frykman’s or Universal classifications did not show meaningful results.Closed reduction and percutaneous K-wire fixation remains an acceptable treatment for extra-articular Colles’ Fractures but this study could not validate its use for intra-articular Colles’ Fractures.

Background: Intetrochanteric hip Fracture commonly affects over 70 years old people. While the best acceptable treatment is early fixation, the complication rate is fairly high because of patients' older age and associated age-related comorbidities. We would like to report our experience with the outcome of fixation of such Fractures in our locality.Methods: In a descriptive study all the intertrochanteric Fractures treated with compression screw-plate system during a 2 year period in two hospitals of Ahwaz were studied.84 patients with mean age of 73.4 (range of 59 to 98 years) were assessed.34 (40.5%) male and 50 (59.5%) female constituted the study group. Patients with a minimum of one year follow-up were evaluated.Results: The complications consisted of 8 (9.5%) varus, 8 (9.5%) shortening, 4 (4.7%) fixation "cut-out", 1 (1.1%) AVN, 13 (15.4%) wound infection and 2 (2.3%) non-union, 9 (10.7%) mortality in 24 weeks.10 (11.9%) underwent reoperation and re-fixation. The average time to returning to pre-Fracture activity was 5 months.Conclusion: Complication rate is relatively high in intetrochanteric hip Fractures even after screw-plate fixation.Except for high infection rate, in our series, the overall results are similar to the other reports in the literature.