IMHS clinical experience in the treatment of peritrochanteric fractures. The results of a multicentric Italian study of 981 cases.

This retrospective study evaluates the results obtained in five Italian departments of traumatology in the treatment of peritrochanteric (pertrochanteric and subtrochanteric) fractures by the intramedullary hip screw (IMHS; Smith & Nephew Richards, Memphis, TN, USA) nail. One thousand two hundred and seventy-three patients were treated with the IMHS nail between March 1992 and February 2000. The results of these operations were evaluated clinically and radiological in 981 patients. The 90.3% of patients could walk unaided or with simple support. Because of the low complication rate requiring re-operation (postoperative shaft fractures, screw penetrated the acetabulum, cut out and non-union) (1.7%), we think that this device is an advance in the treatment of peritrochanteric fractures.

[Cancellous metal implant in the surgical treatment of recurrent post-traumatic shoulder dislocation]. / Spongiosametall-Span in der operativen Behandlung der rezidivierenden posttraumatischen Schulterluxation.

After a short abstract about history and principles in the operative treatment of recurrent dislocation of the shoulder joint and after an illustration of disadvantages and complications in the operative technique described by Eden-Hybinette-Lange, which is favoured in the German speaking area, we are introducing a modification of this technique by use of an implant made from cancellous metal "Lübeck" instead of a bone block. In addition to the introduction of this new technique, first results in 14 patients undergoing this operation are shown up.

Failure of metal-backed uncemented patellar components. Report on 3 cases.

We report 3 cases of metal-backed patellar component failure of the Microloc total condylar knee, which was implanted in 51 cases. The main reason for failure was the design of the patellar and femoral components in combination with flexion of more than 100 degrees.

[Partial femur replacement: implanted without cement]. / Femurteilersatz: zementfrei implantiert.

The following indications are well accepted for subtotal femur replacement: 1. Malignoma of the hip region. 2. Pertrochanteric fractures. 3. Loosening of hip prosthesis in case of large bony defects. The common devices are implanted by use of bone cement,--we report on three cases, treated by cementless subtotal femoral replacements with bony ingrowth surface. The surface design imitates the structure of spongious bone. The mean observation time of our three patients is more than two years, no complaints are to be observed. By intensive permeation of bone in the surface structure we achieve a more advantageous biomechanical situation.