Annales chirurgiae et gynaecologiae
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Femoral shaft fractures in the elderly treated with Grosse-Kempf slotted locked intramedullary nail.
Thirty-one femoral shaft fractures in patients over 60 years of age were treated with the Grosse-Kempf slotted, locked intramedullary nail and followed for a median of 24 months. The patients tolerated the operation reasonably well and the mortality was not higher than the mortality connected with femoral neck fractures. Three reoperations were performed due to intra- and postoperative complications. ⋯ A 9 cm shortening among these was the reason for one of the two poor results in the series. The other poor result was a malalignment of the distal fragment in a statically locked fracture. We conclude that locked intramedullary nailing is a good way to treat femoral shaft fractures in the elderly, the high subtrochanteric, midshaft and infraisthmic fractures.
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We carried out a four to twelve year follow-up study in thirteen patients aged 63 years and over who were operated on for lumbar disc herniation. In eleven cases the herniation was at the L 4-5 level and in two at the L 5--S 1 level. Additional bony entrapment was present in eight cases. ⋯ Disc removal through a hemilaminectomy or laminectomy with the necessary lateral decompression of the bony entrapment gave a good or excellent result in each of the five patients. It is concluded that disc operation in the elderly usually gives acceptable late results. When even a minor bony stenosis is present at the disc herniation level, hemilaminectomy or even laminectomy should be considered.