The increasing rate of hip fractures is giving rise to a number of socioeconomic problems for the aging community. In addition to being unable to resume their previous living habits, many patients fail to achieve full functional recovery after the fractures. Total hip arthroplasty (THA) is a successful operation for the majority of patients with all forms of hip fractures. Dislocation and aseptic loosening are the major reasons for revisions. An additional problem post-THA is the rate of heterotopic soft tissue calcification after total hip arthroplasty, resulting in severely impaired function, pain, and a reduced range of hip motion. In an open study, 37 women who had undergone cementless total hip arthroplasty after accidental hip fractures were treated twice daily with 200 IU salmon calcitonin nasal spray for 12 months. Simultaneously, the patients received one bag of 1000 mg calcium plus 880 IU vitamin D daily throughout the treatment period of 1 year. A parallel group of 38 women with a similar clinical status in terms of hip fractures and cementless total hip arthroplasty were treated with only one bag of 1000 mg calcium plus 880 IU vitamin D daily through the treatment period. The results of this 12-month clinical trial show that 200 IU salmon calcitonin nasal spray per day promotes general independence from foreign assistance, mobility, and fear of further falls in postmenopausal elderly women following THA. Treatment with a salmon calcitonin nasal spray reduces bone turnover serum markers, loss of further bone density, and pain. Additionally, calcitonin promoted the repair of hip fractures and, as a coincidence finding, was associated with a significantly reduced rate of refractures as well as periprosthetic ossifications.
To obtain valid information on stress tolerance of pertrochanteric fractures, we exposed three different methods of osteosyntheses to dynamical stress and the results were compared. The methods of osteosyntheses were application of a 130 degrees angle plate, performing an adjoining osteosynthesis with bone cement or using cephalocondylar nails. The measurements in connection with photographical and roentgenological examinations of osteosyntheses under stress gave the following results: Compared with the other methods treatment with condylar nails gave equal results in static behaviour yet was clearly superior in its dynamic reaction.
This is a report on 18 osteochondral lesions of the talar dome after sprained ankles and ruptured lateral collateral ligaments of the ankle. They were classified according to Berndt & Harty. The treatment of choice in recent flake fractures is the reduction and glueing with fibrine. Very good results were obtained according to Weber. The recommended treatment of ancient flake fractures frequently occurring to elder patients is the removal of the fragment and the drilling of the subchondral bone.
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