Shaft fractures of the tibia and fibula are trending upwards. Nowadays, close intramedullary nailing technique with transversal locking is a modern method applied successfully in Europe and America for numerous complicated fractures. For that reason, from October 1999, we improved the equipments (operating table, Kuntscher nail) to implement this technique at Saint-Paul Hospital in 42 cases of multiform fractures. The initial results are satisfactory: no infection, no iterative operations by other procedures, hospitalisation time about 5 days, light deambulation after 1-1.5 months in the majority of patients, relative good anatomical recovery, good esthetis result. Acceptable angulation of the fracture in 3 cases was observed.
Tibial Fractures ; Fracture Fixation, Intramedullary

Background: In 24 years, Expanded Programe on Immunization\r\n', u'(EPI) at Thua Thien Hue province achieve high efficiency, reduce remarkably infection rate of children disease in EPI. Objectives: Assessment of instruments and cold chain at City, District Health Center and Commune Health station. Assessment of knowledge and practice EPI of medical officers in districts and communes. Subjects and method: Instrument, cold chain system and officers at City, District Health Center and Commune Health station. Method: Cross-section descriptive study; Observe instruments and cold chain at Health stations and fill in available forms. Interview medical officers, observe practical manipulation and fill in available forms. Results: The rate of good knowledge varied from 61,64% to 94,55% and the rate of appropriate practice was from 45,70% to 80,92%. On average, each commune health station had 0,421 refrigeration; 0,128 ice cabinet; 0,258 cold box; 2,259 thermoses; 6,623 ice packs; 2,826 thermometers and11,321 safe boxes. All commune health stations have vaccine containing thermos; one station has no thermometer; two have no safe box and five have no ice pack. Conclusion: All commune health stations have essential instruments, cold chain. Very few health station lack of one or some types. Medical officers almost have basic knowledge about expandedimmunization, the rate of answering right theoretical questions from 61,64% to 94,55%. Practical manipulation had still many errors, rate of manipulation right only 45,70% to 80,92%. District officers manipulated right higher than commune officers.\r\n', u'
Refrigeration/ instrumentation ; Vaccination/ instrumentation ; mortality ; methods ; Health Knowledge ; Attitudes ; Practice ;

Objective: The risk of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from schoolchildren to their household and the protective effects of vaccination in these settings remain poorly understood. We assessed the transmission dynamics of schoolchildren with SARS-CoV-2 within their households and the protective effects of coronavirus disease (COVID-19) vaccination among household members in Viet Nam. Methods: We estimated the attack rate, vaccine effectiveness and adjusted risk ratio (aRR) of factors associated with SARS-CoV-2 transmission to household contacts of children confirmed to have COVID-19 who attended three schools in Ha Nam, Phu Tho and Thanh Hoa provinces between September and December 2021 using multivariable regression with household-level random effects. Results: This retrospective cohort study included 157 children infected with SARS-CoV-2 and their 540 household contacts. The attack rate among household contacts was 24.6% (133/540). Overall, vaccine effectiveness among household contacts was 39% (95% confidence interval [CI]: -1 to -63), higher among males than females and higher in adults aged >40 years. COVID-19 transmission was greater among female household contacts compared with males (aRR: 1.35, 95% CI: 0.94 to 1.95), although not statistically significant, and highest among those aged 19–39 years (aRR: 2.51, 95% CI: 1.50 to 4.21). Fully vaccinated household contacts had significantly lower infection risk (aRR: 0.46, 95% CI: 0.26 to 0.84). Discussion: We found substantial onward transmission of SARS-CoV-2 from schoolchildren to household members, and older people were more likely to be protected by vaccination. We recommend that schoolchildren and all household members living with schoolchildren receive at least two doses of a COVID-19 vaccine. Recognizing the role of schoolchildren in the onward transmission of COVID-19 is an important lesson learned by Viet Nam that can help not only in managing other outbreaks but also in protecting schoolchildren by predicting the progress of the outbreak and preparing for a timely response.