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To evaluate the efficacy of Kirschner wires and tension-band fixation through posterolateral minimal incision for the treatment of displaced supracondylar humeral fractures in children.From January 2005 to December 2010, there were 62 children (38 males and 24 females, ranging in age from 2 to 14 years, averaged 6.8 years) with Gartland type III supracondylar humeral fractures. All the injuries were caused by falling, and all the fractures were fresh injuries. The duration from injury to surgery ranged from 5 to 20 hours. All the children were treated with open reduction through a posterolateral minimal approach, Kirschnere wires and tension-band fixation were fixed with plaster at 90 degrees of elbow flexion, forearm supination, and palms facing upwards. The kirschner pins and wires were removed after fractures healing. The Flynn's criterion was used to evaluate therapeutic effects.The operation time ranged from 30 to 50 min (averaged 45 min). All the patients achieved solid union. Sixty patients were followed up, and the mean follow-up time was 15 months (ranged from 6 to 24 months). At the 6th month after operation, 48 patients got an excellent result, 9 good, 3 bad (light cubitus varus with varus angle about 6 degree, without infection on function) according to Flynn's criteria. There were no complications such as procedure-related pin tract infection, iatrogenic nerve and vascular injuries and myositis ossificans.The Kirschner wires and tension-band fixation through posterolateral minimal incision approach can obtain clearer surgical field, simple in operation, and few wound complications. Therefore, this modified treatment is an effective and reliable method for pediatric displaced Gartland type III supracondylar humeral fractures.

Total hip arthroplasty or hemiarthroplasty are used to treat displaced femoral neck fractures. However, the optimal treatment of these fractures remained controversial. To assess the effects that compare total hip arthroplasty with hemiarthroplasty for the treatment of femoral neck fractures in the elderly. We searched MEDLINE (January 1980 to 2010), EMBASE (January 1980 to 2010), and the Cochrane Library 2010; issue 1. Only prospective randomized controlled trials (RCTs) that compare total hip arthroplasty with hemiarthroplasty for the treatment of femoral neck fracture in the elderly were included. The analysis was performed with software RevMan5.0 from the Cochrane Collaboration. We identified seven relevant randomized controlled trials with a total of 828 participants. The meta-analysis showed relative risk of re-operation was 0.40 (95% CI = 0.24–0.67, P = 0.0004), the dislocation was 2.02 (95% CI = 1.26–3.25, P = 0.002), the mobility as functional outcome was 1.70 (95% CI = 1.21–2.38, P = 0.002). It was reported that the average operating room times and blood loss volumes in total hip arthroplasty were more than in hemiarthroplasty (P