A modified transgluteal approach to the hip joint without osteotomy of the trochanter is described. The advantage of this approach is a better view of the acetabular rim, prevention of gluteal muscle damage and protection of the superior gluteal nerve.

A 21-year-old male patient was treated for idiopathic scoliosis in a general orthopedic practice. Despite treatment a steady increase of lumbar bulging was noted. An extensive soft tissue tumor was found to be the cause of this. The tumor was resected locally at the orthopedic department and was found to be histologically an aggressive fascial fibromatosis. Radiologically the vertebral column showed hemihypertrophy of the pedicles and transverse processes of Th 10 through Th 12 on the ipsilateral side. Since the resection could not be considered radical, local radiation was applied with telecobalt (60 Gy focal doses). Three years later, there is no sign of local recurrence.

Without any known specific cause a 3-year-old boy developed a torticollis. Although the symptoms were treated immediately there was no improvement. Four months later X-rays showed that the dens-atlas distance was enlarged. In spite of this, he was treated by tenotomy and intensive physiotherapy, but the torticollis remained. Two years later a tomogram and a CT showed a complete rotatory dislocation between atlas and axis. At this stage it was impossible to treat the original cause. Physiotherapy was continued to improve the position of the head.

We report on the follow-up examination results of 881 operated hip joints which were implanted in the Innsbruck University Clinic for Orthopedics during the period 1968--1975. Due to exact checking 75% of all patients could be clinically control-examined during 1978 and all available information regarding the others was collected. In the patient group with an average age of 62.5 years the course of postoperative mobility over the years was mainly examined. Functional activity, subjective patient opinion, pain, work capability and weather sensitivity were also analyzed. After an implantation period of the hip prosthesis of 3--10 years encouraging results were shown. Aseptic prostheses loosenings (9.8%) were examined with regard to their causes. The infection rate was very low at 0.56% and also periarticular calcification only occurred comparatively seldom (13.5%). Other complications were recorded in 6.8% of the patients. In total, 74% of the operated patients offered a very good or good complete result.

Years ago a 20-year-old patient presented with low back pain. Radiologically a cystic lesion of the sacrum was found and interpreted as malignant tumor. Without biopsy and histological diagnosis the patient was given radiation therapy with 21 000 rad. One year later a similar lesion was radiated in the left femoral neck. A pathological fracture ensued recessitating several operations. Twenty years after initial radiation therapy the patient developed a rapidly growing tumor of the sacrum, metastasizing to the lungs. One year later he died.