During 1982, 118 patients with clavicular fracture were treated in the Department of Orthopaedics and Traumatology, Helsinki University Central Hospital. Eighty-nine patients appeared for the follow-up examination in 1984. Eighty-three fractures were treated with immobilization in a sling. Four fractures were treated with plate fixation primarily and two patients were operated on for delayed union. The immobilization averaged 21 days, range 10-42 days. The follow-up was 2 years in all cases. The result was good in 65 cases, satisfactory in 20, and poor in 4 cases. Patients with primary dislocation of more than 15 mm or with shortening observed at the follow-up examination had statistically significantly more pain than patients without these findings.

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We describe six patients with aggressive granulomatous lesions around cementless total hip prostheses. Two patients previously had a cemented prosthesis in the same hip. The Lord prosthesis was used in five patients, the PCA in one. Both prostheses were made ofchrome-cobalt alloy. Pain on weight-bearing occurred on average 3.2 years after the cementless arthroplasty, and at that time radiography revealed aggressive granulomatosis around the proximal femoral stem and the acetabular component in five of the patients; one had a large solitary granuloma in the proximal femur. Revision was performed on average 4.8 years after the cementless arthroplasty. At that time all granulomas had grown large in size; while waiting for revision operation, two femoral stem components fractured. All the granulomas showed a unifonn histopathology, which included histiocytosis; the cause for these lesions was thought to be plastic debris from the acetabular socket. granulomatosis may also occur around uncemented prostheses.

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Twelve patients were operated upon after unsuccessful conservative treatment for complete dislocation of the sternoclavicular joint. Three methods were used; stabilisation using fascial loops, reconstruction with a tendon graft, and resection of the sternal end of the clavicle. The results were good in only four patients, three treated with a tendon graft and one by fascial loops. Another four patients had fair results, but all four treated by resection of the medial end of the clavicle had poor results, with pain and weakness of the upper extremity. In our opinion resection of the sternal end of the clavicle should not be used in old traumatic dislocation.