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A new measuring device has been developed at the Orthopedic Clinic of the University of Tübingen. Its task is to ensure that the right length of leg is selected intraoperatively. The method of measurement can be used in all approaches for alloplastic hip replacement when the patient is in the supine position. Measurement is quick, non-invasive, and can be carried out in a direct comparison to the contralateral leg, using measuring points at the iliac crest and the upper edge of the patella. In a prospective randomized study we were able to demonstrate on 53 patients that the use of this newly-developed measuring device improves the accuracy of the length of the operated leg as compared to the contralateral leg, so that the difference is only +/- 0.5 cm (post-operative difference in length of leg without use of the measuring device 1.1 cm on average, with the measuring device 0.5 cm; p < 0.05).

and nitrogen following subtotal gastrectomy is not completely understood. Wollaeger suggested several explanations for such losses: (1) rapid emptying of the stomach, (2) "intestinal hurry," (3) diminished flow of pancreatic secretions and bile, and (4) imperfect mixing of food with digestive juices.1 Everson expressed the opinion that the reservoir function of the stomach was most important and that food was assimilated when released intermittently and in small amounts.2 Emery also emphasized the importance of the stomach as a regulator of the passage of food into the intestine.3 A procedure which would impose a partial resistance at the outlet of the gastric remnant following subtotal gastrectomy might improve the reservoir function of the remaining stomach by retarding the passage of its contents. Improved mixing of food with digestive juices and absorption of the products of digestion might also be expected.The purpose of this study was to observe the effects upon gastrointestinal motility and nutrition of a reversed jejunal segment interposed between the gastric remnant and the first loop of jejunum following subtotal gastrectomy in 6 dogs.As early as 1896, experiments in which a segment of intestine was isolated from the intestinal tract on its fan of mesentery, reversed end-for-end, and anastomosed back into the intestinal tract have indicated that the polarity of peristalsis in the segment was retained and that the degree of resistance to the flow of gastrointestinal contents produced was proportional to the length of the segment reversed.4, 5 Most investigations that employed long lengths of reversed intestine terminated with the conclusion that intestinal obstruction eventually occurred.6 Obstruction did not occur, however, when a short segment was reversed.7 Material and MethodsPreoperative radiographie motility and metabolic balance studies were performed on 10 dogs. Radiographic studies were done by feeding the animals barium-marked meals of their usual food consisting of 3% fat, 12% protein, and 34% carbohydrate. Fig. 1.-Subtotal gastrectomy with 1-inch reversed jejuna I segment interposed between gastric remnant and jejunum.Inset illustrates isolation of segment with attached mesentery from afferent limb of jejunum.Each animal received 25 gm. per kilogram of body weight. An x-ray exposure was taken 5 minutes after the animal began eating and repeated at hourly intervals until the stomach emptied. When the importance of determining the initial passage of gastric contents became apparent, 3 preoperative dogs and 7 others were studied by exposures 5, 10, 15, and 30 minutes after the first exposure, and hourly thereafter.Metabolic studies consisted of 2, 3-day feeding and fecal collection periods preceded by a 3-day equilibration period. A daily diet chemically analyzed and calculated to contain from 12.7% to 13.4% fat, 15.0% to 21.5% protein, and 28.0% to 31.1% carbohydrate and to furnish 80 calories per kilogram of body weight was fed to the animals.Carmine markers were used to demarcate fecal collec...

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