From 1984 to 1991 439 patients with fractures of the coxal femur (303 femoral neck fractures, 136 pertrochanteric fractures) were treated by primary arthroplasty. The average age of the 370 female and 69 male patients was 80.9 (+/- 9.9) years. In 368 patients (83.8%) concomitant diseases were diagnosed and 212 patients (48.3%) showed more than 1 risk factor. There were 205 alloarthroplasties and 234 hemiarthroplasties performed. The percentage of patients treated by total hip endoprosthesis was 31.2% in 1984 and increased to 63.1% in 1991. In 49.2% of all cases general complications occurred, pre-dominantly nosocomial infections and pressure sores. Local (surgical) complications were diagnosed after 10.5% of all operations. The 30-day-mortality was 5.2%, the in-hospital-mortality 5.9%. Statistical analysis by multivariate logistic regression showed an independent negative influence of pre-operative immobility, pertrochanteric fractures, diabetes mellitus and multiple concomitant diseases on mortality. Age, sex or other single risk factors were not independently associated with an increased mortality. Patients with the above mentioned risk factors are easy to identify pre-operatively and do perform better after intensive preparation, short operation time and early mobilisation after surgery.

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Complete dislocation of the knee is rare but frequently associated with popliteal artery disruption. Prompt recognition and early revascularisation are paramount for a successful and functional result. We report on a case of anterior dislocation of the knee complicated by concomitant popliteal artery injury. The value of pre-operative diagnostic methods including pre-operative arteriography and Doppler-sonography is discussed. Review of literature is presented.

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Forty-four patients undergoing elective hip joint operation were analyzed to assess whether a new slit-suction drainage is less painful than the regular Redon-suction drainage. Main endpoint of the study was the effectiveness to draw off secretion and the pain at the time of removal of the drainage. Other endpoint was the rate of postoperative complications. At the time of removal patients with slit drain rarely complained about pain (p < 0.01). On contrary, patients with Redon drain always complained about pain. Clotting were seldom shown in slit drains and were frequently shown in Redon drains. Both slit drains and Redon drains were effective to drain secretion. As the new slit drain was more comfortable for patients following hip joint repair slit drain should always be used as suction drainage.