Subclavian vessel injury from chest-drain malposition in the treatment of a pneumothorax in the presence of a lateral third open clavicular fracture.

We report the unorthodox injury of the subclavian vessels by the malposition of a chest drain, for the treatment of a pneumothorax in the presence of a lateral third open fracture of the left clavicle. This case presents the first report of a ruptured subclavian vein and cephalic vein after the insertion of a chest drain for a pneumothorax. A systematic search performed in MEDLINE, EMBASE, Cochrane Library, and Web of Science found no similar cases documented in the literature.

Association of intra-operative metaphyseal fractures with prosthesis size during hemiarthroplasty of the hip.

Purpose: To study the possible causes of intra-operative metaphyseal fractures in elderly patients undergoing hemiarthroplasty for displaced intracapsular femoral neck fracture.

Methods: 36 men and 228 women aged 61 to 89 years with 273 displaced femoral neck fractures underwent hemiarthroplasty using a hydroxyapatite ceramic-coated Furlong bipolar prosthesis. Anteroposterior and lateral radiographs were taken immediately after surgery to evaluate the presence and type of any intra-operative fractures (classified according to the Vancouver system) and their effect on stem stability or osseointegration.

Staged bilateral hip or knee arthroplasties.

Purpose: To compare the operating time, amount of blood transfused, length of hospital stay, and early complications (within 6 months) between 2-week staged bilateral arthroplasties and matched randomised controls undergoing unilateral arthroplasties.

Methods: From October 1992 to October 2000, 90 patients who underwent bilateral hip or knee arthroplasties with a 2-week interval were compared with matched randomised controls undergoing unilateral arthroplasties. A single surgeon performed all procedures.

Flexible intramedullary nailing versus external fixation of paediatric femoral fractures.

Treatment outcomes were compared in two groups of children with femoral diaphyseal fractures which were treated with external fixation (20 fractures) or flexible intramedullary nailing (20 fractures). These 40 children were between 5.4 to 14.

Open medial placement of Kirschner wires for supracondylar humeral fractures in children.

Purpose: To assess the efficacy of our protocol for treatment of displaced Gartland type-3 supracondylar fractures of the humerus in children.

Methods: Records of 43 children with displaced Gartland type-3 supracondylar fractures of the humerus admitted from October 1997 to October 2003 were reviewed. Patients were treated within 12 hours of admission by closed reduction (n=33) or open reduction (n=10).