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.

Context: Flexible intramedullary nails have been reported to provide a stable humeral fixation with satisfactory results in terms of union and complications. In this study, Kirschner wire (K‑ wire) was used to achieve a closed intramedullary fixation of humeral shaft fractures. Subjects and Methods: This study included forty cases of the displaced diaphyseal fracture of the humerus based on inclusion and exclusion criteria. The study was done at Kasturba Hospital, Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sevagram, between the periods January 2003 and November 2006. All the cases were operated after clinical evaluation. The final evaluation of the result was done by Qidwai’ s clinical and radiological criteria. Results: A total of forty cases were available for the study. K‑ wire of different sizes was used; the average duration of surgery was 45. 3 ± 7. 2 min. The average time taken for radiological union was 12. 1 ± 1. 9 weeks. The patients were analyzed by Qidwai’ s criteria and had excellent result in 30 (83. 3%) cases, good in 4 (11. 1%) cases, and poor in 2 (5. 6%) cases. Three patients were lost to follow‑ up, and one patient was died due to medical illness. Conclusion: Intramedullary K‑ wire fixation is a satisfactory, safe, simple, minimally invasive technique and cost‑ effective treatment for humeral shaft fractures. It gives elastic mobility and stability.

Background: Supracondylar humeral fractures constitute about 60% and 13% of all pediatric elbow and pediatric skeletal fractures, respectively, with a peak incidence in the 5-7 years age group. The aim of this study was to evaluate and compare closed reduction with open reduction and Pin fixation in type III supracondylar humeral fractures in children younger than 12 years. Materials and Methods: In this retrospective study, all children under 12 years of age with type III supracondylar humeral fractures who referred to two teaching hospitals in Mashhad, Iran, between March 2017 and March 2019 were included. Patients were divided into two groups: open reduction and fixation with Pin (OR) (n= 30), and closed reduction and percutaneous Pinning (CR) (n=15). The method of surgery for each individual patient was chosen based on the surgeon’ s preference. For patients who had a follow-up of at least 6 months, subsequent elbow radiographs were requested. Results: No significant differences were observed between the two groups in terms of range of motion of the fractured limb and radiographic angles at follow-up (p > 0. 05). However, operation time was significantly shorter in the CR group compared with the OR group (p < 0. 001). Three patients (6%) had cubitus valgus (all of whom were in the OR group [10%]), and two patients (4%) had cubitus varus (one patient in the OR group [3. 33%] and the other in the CR group [5%]). Wound dehiscence was only seen in one patient in the OR group (3. 33%). Conclusion: Based on the results, there was no significant difference between the open and closed reduction methods in type III supracondylar humeral fractures with respect to elbow function and union of the fracture.

Background: Gorham's disease (GD) is one of the scarce and idiopathic skeletal diseases which causes osteolysis following the proliferation of blood vessels. Progressive osteolysis GD of distal humerus with articular involvement and pathologic fracture has not been reported and our case is the first report of this disease involving distal humerus and its joints’,surfaces. Case Report: A 9-year-old boy, case of nonunion of medial condyle of humerus and pathologic fracture of distal humerus after minor trauma, was referred to our clinic and treatment started by casting but due to displacement and nonunion, we decide to operate him. Intraoperative finding was in favour of aneurysmal bone cyst (ABC) near fracture site,therefore, wide resection and fixation by medial tension band wiring (TBW), lateral plating, and fibular allograft application was done (post-operation pathologic result did not show microscopical features of this tumor) and 6 weeks later, he developed stress riser fracture above lateral plate,thus, plate removal was done and severe bone resorption was revealed. Therefore, another specimen was sent for pathology that showed hamartomatous and hemangiomatous lesion of bone. All findings were in favour of GD. He was operated another time and fixed by Persian fixation with small Pins and plate, and early plate removal was done for prevention of stress riser fracture. Conclusion: In cases of GD of distal humerus and pathologic fracture, Persian fixation is a good option for fixation and we suggest early device removal for prevention of stress riser fracture.

Background: A better sternal fixation reduces the attendant risk of superficial and deep infection and enhances postoperative respiratory mechanics, thereby fast-tracking the patient’ s recovery and rehabilitation, as well as professional re-insertion. The aim of this study was to evaluate the safety and efficacy of wire-Box fixation as an alternative technique for sternal closure after median sternotomy. Methods: This case-series study was conducted on patients undergoing routine sternal closure after median sternotomy, which was concluded with wire-Box fixation. The current method can be executed with a sternal wire number 5 or 7. First, a figure-of-eight (FOE) stitch is placed on the manubrium. Then, a stitch is placed above the inferior loop of the previous one in its hole. It is thereafter exited out above the former wire and turned around downstream (interlocking) to profile the second FOE stitch so as to dress the Louis angle between the manubrium and the sternal body. This procedure is repeated until a total number of 4 to 5 interlocking FOE stitches are placed in proportion to the sternal length. When placing an FOE stitch, care should be taken to stitch perpendicularly and staying trans-sternal to decrease the risk of iatrogenic bleeding. Results: In total, 191 patients at a mean age of 56. 0± 14. 4 years were enrolled. The mean pain score level on the first postoperative day, based on a visual analog pain scale, was reported to be 4. 8± 2. 1, while it was reported to be 2. 1± 1. 4 on the day of discharge. No sternum instability, dehiscence, or revision surgery was reported with the usage of wire-Box fixation. An incidence rate of 0. 51% was reported for wound infection and 4. 1% for death unrelated to wiring. No further complications were reported during a 3-month follow-up. Conclusions: It appears that wire-Box fixation is an optimal technique of sternal fixation given its prominent advantages of low cost, rapid installation, and low incidence of complications.