Brush cutting is a commonly performed activity occupationally as well as recreationally in Malaysia. There are various occupational injuries reported related to brush cutting, for example foreign body penetration. There were 11 reported cases of foreign body penetrated in leg of brush cutting workers admitted to orthopaedic ward in Hospital Raja Permaisuri Bainun from the period of January till October 2009. Among the cases, 4 were surgically removed under local anaesthesia and 7 cases performed under general anesthesia. 2 cases reported foreign body penetrated into tibia bone. There were many contributing factors to the injury, which include lack of protective measures for workers, engineering property of brush cutting machine and education on handling of equipment. It is vital to study the factors separately in order to determine and recommend useful preventive measures. However, the actual numbers of cases are under reported and awareness of the problem is undermined.
Interlocked intramedullary nailing is accepted as the gold standard for femoral shaft fractures. However for Winquist type I and II femoral fractures at the isthmus region, unlocked intramedullary nailing (Küntscher nailing) is still a good option. We performed a retrospective study on 86 patients with a total of 88 femoral shaft fractures around the isthmus that presented at our institution between 1 January 1988 and 31 August 2003. All patients (84.1% Winquist type I and 15.9% Winquist Type II fractures) were treated with unlocked intramedullary nail. The average time to union was 16 weeks with 97.7% rate of union. There were two cases (2.3%) of infection and non-union each. Overall results were comparable to standard interlocking intramedullary nailing. We conclude that unlocked intramedullary nailing is a good treatment option for Winquist Type I and II femoral fracture around the isthmus with its good union rate and minimal complications.