A retrospective review is presented of 72 patients who sustained frontal sinus fractures (FSF) and were subsequently treated by the department of otolaryngology/head and neck surgery between the years of 1974 and 1986. Eighty-four percent of FSF occurred in males and 71% were a result of motor vehicle accidents. Only 24% remained conscious at the time of trauma, and in only one third of the cases was there no other fracture. Seventy-six percent of FSF involved both the anterior and posterior walls--a figure that possibly reflects the referral patterns to a hospital that is a major regional trauma center. Patients were treated with a variety of procedures including cranialization (42%), osteoplastic flap and fat obliteration (30%), open reduction and internal fixation of the anterior wall (20%), osteoplastic flap and sinus ablation (6%), and intersinus septectomy (1%). Some difficulty was encountered in documenting sustained follow-up, which ranged from 2 months to 9 years, and averaged 22 months. Nine percent of patients died in the post-trauma period. Minor complications were relatively common, but major complications occurred in only 10% of patients. Four patients (6%) suffered meningitis (although the portal of infection was not necessarily through the frontal sinus); one patient (1%) suffered severe pain over the sinus and forehead for at least 12 months after surgery; and a mucocele developed in four patients (6%).

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We describe a new revision technique for Vancouver B periprosthetic hip fractures that leaves the original acetabular components in situ and causes minimal damage to the hip capsule. Twentyeight patients, average age 79, with Vancouver B periprosthetic fracture had femoral component revision using a modified trochanteric osteotomy with a minimal superior hip capsulotomy. A modular uncemented stem was used with or without cortical strut allograft. The acetabular component was not revised. Fractures occurred in 19 cemented implants and 9 uncemented implants. There were no dislocations. Seventeen patients were available for follow-up at 24 months (range, 3 to 60 mo), average Oxford hip score was 32.2; and Harris hip score 69.7. This new technique has shown good results. We believe that the absence of dislocation in this series is largely attributable to minimal capsular dissection.

We describe a case of a 19-year-old male who presented to the South West Health Service with a septic knee, secondary to haematogenous spread from an iliacus abscess. Thus far, there have been no reported cases of haematogenous spread of infection from an iliacus abscess to an ACL reconstructed knee, let alone in a healthy young person with no risk factors. The patient has had several washouts of the knee along with the drainage of the abscess. The ACL graft was saved with the patient making a complete recovery.