Insufficiency fractures secondary to prolonged alendronate use is due to inhibition of osteoclastic activity and suppressed bone turnover. Complications of fracture fixation include non-union, mal-union, and difficulty in intramedullary nail insertion. We report a technical challenge in intramedullary nailing of an obliterated femoral canal in a patient on long-term bisphosphonate treatment. Th...

Abstract Aim Dynamic hip screws (DHS) and short intra medullary (IM) nails are fixation methods used for neck of femur (NOF) fractures. Both require fluoroscopic assistance within the operating theatre, therefore exposing surgeon patient to ionising radiation. There is minimal literature investigating radiation exposure. Aims this study compare doses in each procedure estimate a normalised dose...

BACKGROUND Flexible intramedullary nailing has emerged as an accepted procedure for paediatric femoral fractures. Present indications include all patients with femoral shaft fractures and open physis. Despite its excellent reported results, orthopaedic surgeons remain divided in opinion regarding its usefulness and the best material used for nails. We thus undertook a retrospective study of pae...

Abstract Aim Short intra medullary (IM) and long nails are fixation methods used for proximal femur fractures. Both require fluoroscopic assistance within the operating theatre, therefore exposing surgeon patient to ionising radiation. There is minimal literature investigating radiation exposure. Aims of this study compare doses in each procedure estimate a normalised dose. Method Retrospective...

Technical errors during intramedullary nail insertion are not uncommon. We report a case of tibial guide wire penetration into the distal tibial articular surface, the talus and the calcaneus during insertion of the nail with the ankle dorsiflexed. This has not been reported in the past. Computerized tomogram was a useful tool in the diagnosis. This complication was associated with long-standin...

The treatment of comminuted tibial shaft fractures in canine patients is burdened by significant risk which involves bone healing complications, such as delayed bone union. Complications may result from iatrogenic damage to blood vessels during fracture stabilization. To minimize this risk, treatment methods increasingly often rely on the concept of biological osteosynthesis. One of such method...

The risks of operating on fractures-sepsis and delayed union-are nowhere greater than in the tibia because this bone is covered only by a thin layer of skin and subcutaneous tissue in a region of poor vascular reserve. Medullary nailing allows internal splinting without exposure of the fracture; it confers the benefits of accurate reconstruction, absolute immobilisation and unrestricted movemen...