In tension band wiring different tensioners and wire-connections are in use. Both of these were examined on tensile force during and after connection with help of a material-testing machine. Additionally the different connections were examined under traction-load. The results show that none of the tensioners for monofilament wire are capable of establishing a permanent tension at the end of the fixation-procedure. Consequently we must ask if the theoretical principle of B. G. Weber concerning tension band wiring is efficient in practice. Only the use of twisted wires in combination with fixation clamps could produce a permanent tension. The limit of elasticity is 2 to 3% for monofilament wires as well as for twisted wires. Further stretching causes plastic, i.e. irreversible deformation in monofilament wire and its connections. In twisted wires further tension stress causes ruptures especially at the border of the fixation clamp. In conclusion extreme active exercise of fractures treated with tension band wiring should not be emphasized.

The attachments of the anterior and posterior horn of the menisci to the tibial plateau are of a most important functional value. At the medial meniscus the circumference is more widely configurated, because of the greater distance between anterior and posterior horns. The areas of sagittal cuts through the menisci slightly differ regarding medial and lateral side. A higher area momentum of inertia of the medial meniscus, related to a vertical axis within the examinated sagittal plane, is found. It derives from a geometrical distribution of partial areas more distant from the axis. The medial meniscus therefore has a higher stiffness against sagittal bending stress. Experiments and theoretical stress simulation prove these results. According to them, the medial meniscus is less mobile in comparison to the lateral. These findings are discussed as a basic geometrical cause for the higher incidence of injuries of the medial meniscus.

In adults pathological fractures of the femur are mostly caused by skeletal metastases. In our own collective of femoral fractures 58 were caused by skeletal metastases and five by multiple myeloma. Average age was 59.8 years, women prevailed. In most of the metastatic fractures breast cancer was found to be the primary tumour. In all cases fracture stabilization as a palliative measure was the only possible therapy. Two patients could not be operated on because of other vital problems. In femoral neck fractures resection and endoprosthesis was the operative measure of choice. The pertrochanteric and subtrochanteric fractures were mostly treated by composites of cement and the 95 degrees condylar-plate. Also in shaft fractures cement-implant composites were performed with straight plates. Rarely, intramedullary nailing was done. Exercising stability could always be achieved, weight-bearing stability in most of the cases. The mean survival time was 7.2 months regarding 43 patients with well documented course. Six patients are controlled regularly, the operative treatment was done on an average 16 months before.

For a large scaled test 52 patients with anterior transposition of the ulnar nerve and 62 patients with elbow injuries were examined by questionnaire, physical examination and electroneurography. In conformity with existing literature 24 patients out of 52 suffering from cubital tunnel syndrome had an elbow trauma previously. To our great surprise in seven patients out of 46 with elbow injuries a cubital tunnel syndrome could be found for the first time. The cubital tunnel syndrome appears to be a frequent complication of elbow injuries. Besides the well known fractures of the medial epicondyle and pericondylar fractures leading to cubital tunnel syndrome, in our study fractures of the head of the radius and processus coronoideus were found quite often. Patients having typical anamnesis and complaints should be checked by electroneurography in order to permit a quick operation and to prevent incurable damages of the nerve. The diagnosis leading to operation of the elbow should however be made with greatest care. In case the operation is unavoidable, the ulnar nerve should be thoroughly checked and anterior transposition should be carried out.

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