[Comminuted intra-articular fractures of distal humerus treated with minimal fixation, one of treatment options].

Fractures of distal humerus on human skeleton are rare and intraarticular fractions of distal part of humerus occur even less freqvently, they comprise abouth 3% of fractures of humerus. However,these fractures can result in a functional deficiency of elbow joint and permanent disability. The main goal if our work was to present one of the surgical treatment options of this kind of fracture with minimal amount of fixation material. Treatment result were evaluated by Broberg-Morrey score system. Pilot study consisted of eight patient with comminuted type IV fracture of distal humerus during 2004-2005 time period. Comminuted fracture was fixed with minimal amount of material: a Kirchner needle and a screw. Patient treatment progress was evaluated initially and followed up after four, nine and twenty four months by B-M score after removal of cast and bone fixing material. The results of the B-M score after four months were: excellent in 0 patient, good in 2 patients, fair in 4 patients and poor in 2 patients. After physical therapy and follow up check- up at the end of nine months the result were: excellent in 3 patients, good in 3 patients, fair in 2 patients and no patients had shown poor result. This B-M score result was identical after 24 months follow up with minor deviations in range of motions of elbow, which did not influence the final result of B-M score.

[Late methylene blue appearance in urine after local treatment of cutaneous fistula in hip osteomyelitis as a first sign of renal failure].

Methylene blue is a dark green crystal. In medicine it is used as water or alcohol solution. Methaemoglobinemia, hypotension, septic shock are some of many diseases that are treated with methylene blue. In surgery methylene blue is used in diagnostic procedures such as a fistula detection or detection of the parathyroids glands, and for the delineation of certain body tissues during surgery. In patient with normal renal function methylene blue is appearing in urine in a few minutes after intravenous administration. In our patient who was 70-year-old we remarked interesting phenomena after we instillation methylene blue into the fistila channel during local treatment of hip osteomyelitis. Methylene blue appeared in urine two days after local treatment, coloring the urine light green and color elimination time was prolonged in few days. These parameters induced as to suspect in renal failure. That was prowed after urological, laboratory and radiology examination.