Osteotomy for osteoarthritis of the knee has established itself well since its first description by Jackson and Waugh [8, 9]. Internal fixation with staples allows early functional treatment with only a minimum of operative intervention. Removal of the metal is optional. In the 5-year period from 1986 to 1990, 182 high tibial osteotomies were performed at the Orthopaedic Department of the University Hospital of Freiburg. In four cases internal fixation was done with plates; in 178 cases two or more staples were used; in 3 cases a screw was additionally inserted for better hold. The staples became loose intraoperatively in eight cases (4.5%); only once did a dislocated staple have to be reoperated on post-operatively. Further complications which are independent of the method of internal fixation are summarized in the article. Complications of surgery on the long bones of the leg are inevitable, but with only one postoperatively dislocated staple and one case of non-infected pseudarthrosis (i.e. a method-related complication rate of 1.1%), internal fixation with staples for high tibial osteotomy presents itself as a reliable and safe procedure.

We have quantified the rate and severity of osteoarthritis after the Eden-Hybbinette-Lange procedure. With a mean follow up of 15 years, 44/56 (79%) of operated shoulders showed osteoarthritic changes on radiographic review. Of the contralateral non-operated shoulders the rate of osteoarthritis was 8/60 (8%). Only shoulders in the operated group demonstrated severe osteoarthritis. In our hands the rate of osteoarthritis for the Eden-Hybbinette-Lange procedure is higher than for the Eden-Hybbinette procedure or for rival operations for recurrent dislocation. We recommend careful evaluation of the Eden-Hybbinette-Lange procedure. The high rate of late osteoarthritis indicates that other operations with an equally low rate of redislocation may be of greater long term benefit to the patient.

Evaluating the late results of the Keller-Brandes operation for hallux valgus in 100 feet on average 5.5 years after surgery, these were functionally and cosmetically satisfying to the patient in 90% of cases. In 97% pain was relieved completely or partially. On examination, however, 23% of the feet still had a clinical hallux valgus angle of more than 30 degrees. A dorsal extension-contracture which was found together with 50% or more of phalangeal resection was present in 6%. The power of plantar flexion of the big toe decreased with the extent of resection of the proximal phalanx. Resection of more than half of the proximal phalanx seems to be disadvantageous and should be avoided.

The German version of the NASS Cervical and Lumbar Spine Outcome Assessment Instrument allows the standardized assessment of pain, functional limitations and neurogenic symptoms in patients with back pain and the international comparison of health states and therapeutic outcomes.

The contribution enables interested researchers to apply and score the NASS questionnaire in German-speaking countries.