The problems of hypermobility are getting more and more important. Whereas at high-performance competitive events extraordinary results are achieved in some disciplines by means of early and extremely intensive training aiming at improved flexibility, professional acrobats are not so much the center of attraction as they used to be. This article reports on the basis of examination of 16 competitive sportswomen on a national level, on extreme forms of mobility and on the clinical and radiological findings in "indiarubber" contorsionists and "Klischnigg" acrobats. It was possible to observe and follow up the progression of the extremely rare case of a spondylolysis the lumbar vertebrae L 31 and L 32 as well as concomitant olisthesis L 3/4 and L 5/S 1, over a period of 25 years.

The development of pseudo-arthroses is the most common complication following operative treatment of severe scoliosis. Early recognition of this event is important to prevent recurrence of the curvature. The diagnosis is not possible by radiological examination of the rigid spine. Routine reexploration implies a second operation, which is unnecessary in the majority of patients with stable fusion. In an attempt to develop a non-invasive method for the diagnosis of pseudo-arthroses, bone scintigrams were carried out in 29 patients with idiopathic scoliosis twelve months after a Harrington's spondylodesis. In 24 patients (82.8%) a definite conclusion could be drawn, either of stable fusion (65.5%) or pseudo-arthrosis formation (17.3%). No pseudo-arthroses were missed by scintigraphy. These results indicate that bone scintigraphy plays an important role in the post-operative care after Harrington's spondylodesis.

A Study of Conservate and Operative Treatment of Ankle-Joint Fractures ~ummary. Of 563 patients with fractures of the ankle joint who received conservative treatment between 1962 and 1967, a follow-up examination was performed in 100. Of 280 patients undergoing surgical treatment between 1965 and 1970, 105 presented for follow-up examination. The findings were evaluated according to strict criteria laid down by Weber. Only 450/0 of the patients who received c3nservative treatment showed good or very good results, whereas 840/0 of the surgically treated patients had been successfully or very success. fully treated. This study suggests that at least in types B and C, is surgical treatment is deftnitely indicated.Zusammen/assung. Von 563 Patienten mit Kn6chelfrakturen, die in den Jahren 1962 bis 1967 konservativ behandelt wurden, konntsn I00 Patienten nachuntersucht werden, w/~hrend yon 280 Patienten, die in der Zeit zwischen 1965--1970 operativ versorgt wurden 105 nachuntersucht wurden. Die Beurteilung der Ergebnisse erfolgte unter Anlegen strengster Mailst~be nach Weber. Bei den konservativ behandelten Patienten land sich nur in 43°/0 ein sehr gutes bis gutes Ergebnis, wEhrend bei den operierten Patienten in fast 840/0 ein sehr gutes his gutes Resultat erreicht wurde. Daraus ergibt sich zumindest ffir Typ B und C eine absolute Operationsindikation.Isoelastic Shoulder Prosthesis ~qugtmary. The indications for the implantation of an isoelastic shoulder prosthesis are presented. They are comminution of the humeral head (in carefully selected cases), painful posttraumatic osteoarthritis, and necrosis of the humeral head, and also malignant or benign destructive tumors of the proximal end of the humerus, as long as there are no metastases. An implant made of material of the same degree of elasticity as the bone can be fixed without bone cement. Postoperative check-ups generally show a functionally adequate though restricted range of mobility. Zusammen/a~sung. Indikationen zum Einsetzen einer Schulterprothese sind ansgew~ihlteF~ile traumatiseher Zertriimmerungen des Oberarmkopfes, schmerzhafter posttranmatischer Schulterarthrosen und Kopfnekrosen, sowie semimaligne und maligne Tumoren des proxi. malen Oberarmendes, solange noch keine Metastasen bestehen. Die Fixation einer dem Knochert isoelastischen Prothese aus Polyaeetalharz ist ohne Knochenzement m6glich, l~achuntersuehungen zeigen eine nfitzliche Sehulterfunktion bei eingeschr~nkter Beweglichkeit.~chl~sdu~fter: Iseelastischer Schultergelenkersatz --Zementlose Fixation.

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