The plastination methods were useful methods to analyze the arterial supply of the talus. In our study, the STAR showed a dominant influence on the vascularization of the talus. The fin appeared to be too long. A design modification with a short fin could provide the arterial supply, but should be tested biomechanically.

The functional influence of the medial collateral ligament on the medial meniscus is still discussed controversially. Commonly, a strong fixation of the meniscus by the collateral ligament is described. Injury to the medial meniscus is explained by its reduced mobility due to its strong adherence to the medial collateral ligament. The analysis of 10 plastinated series of the medial femorotibial compartment prove that only few fibres of the ligament radiate into the meniscus. To define the possible contribution of these fibers to the stability of the medial meniscus, experiments on two fresh frozen knee joints were performed. The distal femur was separated by cutting the capsule. The medial collateral ligament was detached carefully from its femoral insertion. The tibial head with both menisci was fixed in a clamping system. A translucent, exact acrylic glass copy of the femoral component to which the medial collateral ligament was reinserted, allowed studying the behaviour of the medial meniscus under axial compression (500 N). Firstly, stress was applied while the collateral ligament was proximally fixed and under tension; then the same experiment was performed after femoral detachment of collateral ligament. All plastinated series revealed only some deep and tender fibrous bundles of the medial collateral ligament radiating into the medial meniscus proximally and posteriorly. The behaviour of medial meniscus was exactly the same in both stress experiment series. The conclusion is that there is no relevant influence of the medial collateral ligament on the stability of the medial meniscus.

The aim of this study was to compare the results achieved in two groups of 20 patients treated for midclavicular fracture. The first group (mean age 36 years) was treated non-operatively with a rucksack bandage, whereas the second group (mean age 37 years) underwent intramedullary fixation with a titanium pin using a minimally invasive, unreamed technique. At follow-up, which averaged 3.1+/-0.9 years in group 1 and 2.9+/-0.7 years in group 2, the result of treatment, as indicated by the Constant score, functional outcome and cosmetic outcome, was significantly better in the group undergoing operative treatment. Clavicle shortening was significantly ( P=0.027) higher in patients treated with a rucksack bandage. The absolute Constant score averaged 78+/-23 in group 1 and 97+/-4 in group 2 ( P=0.001). The Constant rating scale showed a significant difference between patients with clavicle shortening of less than 1 cm and 1 cm shortening or more. There were two non-unions in group 1 but none in group 2. Refractures were not observed in either group. According to these results, intramedullary fixation with a titanium pin seems to be more advantageous in midclavicular fractures than non-operative treatment. As the operation is well received by the patients, it should be offered to them as an alternative treatment to the rucksack bandage.

Fractures of the odontoid process pose a far-reaching danger for elderly patients. A balanced assessment of the general condition should be carried out at the beginning of treatment of these patients. In the early phase following trauma no differences were found with respect to survival rates but for long-term survival the operatively treated group showed advantages; however, these advantages cannot be causally attributed to the choice of therapy.