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The aim of this study was to investigate the predisposing factors, fracture location, treatment, and final outcome of femoral fractures after total hip arthroplasty (THA). From 1975 to 1983, 28 patients were seen with 29 fractures on the same side as the prosthesis. Most of the fractures were caused by minor trauma, and prior hip surgery was the most common predisposing factor. Two patients underwent early operation and six were treated with protected weight bearing. Twenty-one underwent initial skeletal traction, and 14 of these fractures united without further surgery. Six of the patients treated with initial skeletal traction were operated on early, mainly by osteosynthesis, due to poor fracture alignment. Three of these fractures united, but one subsequently required revision arthroplasty because of loosening of the femoral component. Two patients died and three had a permanent pseudarthrosis or a Girdlestone resection. Nineteen of the 21 fractures not operated on united and five of the eight operated united. The results indicate that when good fracture alignment is achieved with traction, union is not jeopardized by either the prosthesis or the cement.

SUlDlDaryA follow-up of 332 consecutive cervical spine injury patients is described. Treatment was with collars (47%), operation (6%), skull traction (24%) and Halo vest (23%).There was a large number of cervical spine injuries at the C2 level, and odontoid process fractures constituted 35% of all cervical spine injuries. The bad reputation of cervical spine injuries with high mortality rates, high non-union rates, and a high incidence of severe neurological impairment could not be confirmed. Traffic accidents affected the younger age categories, and injuries from falls the older ages. The accidents occurred in 95% during leisure, and at least 22% of the patients were under the influence of drugs and/or alcohol. Halo vest treatment gave a low complication rate, a low use of hospital bed days, sick leave and disability pension, compared with operations and skull traction treatment. The complication rate as sociated with the skull traction and operative treatment was unacceptably high. Key words: Cervical spinal injuries; Follow-up study.In the nineteenth century, the diagnosis of a cervical spine injury was made at autopsy in criminals with a fracture dislocation of the axis who had been ex ecuted by hanging. As non-invasive investigation methods such as radiography did not exist before 1895, cervical spine injuries were regarded as rare and fa tal. The interest of these injuries was initially focused on the upper cervical region (Mixter and Osgood, 19lO;Fritzsche, 1913;Jefferson, 1920;Osgood and Lund, 1928). They could only be diagnosed at post-mortem and therefore had a bad reputation.In later studies, however, mortality rates as low as 4% have been reported; 5/63 = 8% (Amyes and Andersson, 1956), 14/77 = 18% (Rogers 1957) and 1/26 = 4% (Nachemson 1960),3/68 = 4% (Althoff 1979).The first publication of a patient treated by an operation was a patient with delayed union of an odontoid fracture (Mixter and Osgood, 19lO). The posterior arch of the atlas was stabilised with the spinous process of the axis with silk.