The present study suggests a shift of the bacterial spectrum towards monomicrobial infections with multiresistant bacteria. The early recognition of high-risk patients and the aggressive surgical treatment with at least double-schema antibiotic therapy are of outmost importance.

We examined the relationship between postoperative dietary intake (DI) of geriatric hip fracture (HF) patients and their functional and clinical course until 6 months after hospital discharge. In eighty-eight HF patients $ 75 years, postoperative DI was estimated with plate diagrams of main meals over four postoperative days. DI was stratified as .50, .25-50, #25 % of meals served. Functional status according to Barthel index (activities of daily living) and patients' mobility level before fracture, postoperatively, at discharge and 6 months later were assessed and related to DI levels. In-hospital complications were recorded according to clinical diagnosis. Associations were evaluated using x 2 and Kruskal -Wallis tests, and repeated-measures ANOVA and ANCOVA. Postoperatively, 28 % of participants ate .50 %, 43 % ate .25 -50 % and 28 % # 25 % of meals served. Irrespective of pre-fracture functional status, patients with DI # 25 % had significantly lower Barthel index scores at all times after surgery (all P,0·05) and ANOVA revealed a significant time £ DI interaction effect (P¼ 0·047) on development of Barthel index scores that remained significant after adjustment for potential confounders. Patients with DI .50 % more often had regained their pre-fracture mobility level than those with DI #25 % at discharge (.50 %: 36 %; . 25-50 %: 10 %; # 25 %: 0 %; P¼ 0·001) and 6 months after discharge (88; 87; 68 %; P¼ 0·087) and had significantly less complications (median 2 (25th -75th percentile 1-3); 3 (25th -75th percentile 2 -4); 3 (25th -75th percentile 3-4); P¼ 0·012). To conclude, geriatric HF patients had very low postoperative voluntary DI and thus need specific nutritional interventions to achieve adequate DI to support functional and clinical recovery.

MPFL reconstruction generally has to be regarded as a safe procedure today due to low patellar re-dislocation rates. Complication rates however are not trivial owing to the complexity of the underlying pathology. Complications can arise from graft fixation or femoral tunnel placement. Postoperative flexion deficits and medial knee pain have been described as predominant complaints. Anatomical preconditions as the grade of trochlear dysplasia, axis or torsion of the lower extremity have to be considered in search of causes for possible graft failure as well as in the thorough preoperative planning of the procedure.

There is still no gold standard for the treatment of humeral shaft fractures. This might be attributed to the fact that several commonly used treatment methods have shown good clinical results. A bimodal age distribution of humeral shaft fractures with frequency peaks between 20 and 30 years old and above 60 years old is reported. Decision making for conservative or operative treatment depends not only on the injury pattern but is also dependent on individual patient needs. Currently available operative techniques include antegrade and retrograde interlocking medullary nailing as well as the use of longer proximal humeral nails. Plate osteosynthesis can be performed as open reduction and internal fixation (ORIF) or as minimally invasive plate osteosynthesis (MIPO). There is currently insufficient evidence for a clear superiority of either of the methods. Radial nerve palsy is the most typical complication of humeral shaft fractures but an improved outcome is not achieved by an emergency revision of the nerve.