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In attempt to standardize an experimental model for biomechanical studies of unstable trochanteric fractures, acrylic models of the proximal femur were investigated by the photoelastic technique. By matching the stress distribution in the acrylic models to those calculated by Pauwels, it was found that the optimal femoral shaft and resultant hip joint force angles were 5 degrees and 6 degrees to the vertical, respectively. The abductor muscle pull was determined to be 55 per cent of the resultant hip joint force at 15 degrees medial inclination to the vertical.

A retrospective study of 1,592 hip fracture patients over the age of 50 years was undertaken, recording the age and sex, the fracture type and treatment, the hospitalization time and the rate of technical failures. Based on the predicted population in the area of admission it was calculated that the number of hip fractures will double within the next 17 years. An analysis of the hospitalization time in relation to the various types of treatment and the rate of technical failures made it possible to calculate the hospital resources required in the future. It was found that despite the considerable increase in the number of hip fractures treatment can be undertaken without further allotment of resources provided a rationalized treatment plan is instituted aiming at the safest possible methods of treatment, as the hospitalization time was found to be considerably influenced by technical failures of the treatment.

Major amputations were performed on 310 patients because of gangrene of the lower limb. The mean age was 70 years and 58 per cent of the patients were males. Females were on average 5 years older. The primary levels of amputation were above-knee (AK) in 33 per cent (103/310), through-knee (TK) in 21 per cent (66/310) and below-knee (BK) in 46 per cent (141/310). Mortality during hospitalization was 18 per cent and the average hospitalization time 68 days. Mortality during hospital stay was primarily dependent on the occurrence of somatic complications, secondarily on the level of the amputation (as an expression of the extent of the gangrene) and finally on the age of the patient. The long-term survival rate was correlated primarily to the level of the amputation and secondarily to age. A high excess mortality was noted during the first few postoperative years, especially among AK amputees, but after this period the survival curve ran parallel to the expected survival rate. Mortality after 1 year was 34 per cent, comprising 17 per cent after BK amputation, 39 per cent after TK and 54 per cent after AK amputation.

A comparative analysis of the information contained in five different classification systems was performed. The system classifying the fractures into five types in relation to the comminution of the calcar femorale or greater trochanter was found to be superior to the others, as it contained the most reliable information about the possibility of obtaining stable fracture reduction and gave the most accurate prediction of the risk of secondary fracture dislocation.

The photoelastic technique was applied to acrylic models of unstable trochanteric fractures. Model osteosynthesis was performed on nail-plates with different angles. An increase of the angle between the nail and plate was shown to reduce the shear force between those two components considerably. From mecnanical considerations it is recommended that a steep placement of the nail-plate is advantageous in osteosynthesis of unstable trochanteric fractures without medial support.

The incidence of hip fractures in the period 1971-1976 was calculated. The overall incidence was about 3 per thousand above the age of 50 years and about 20 per thousand above the age of 80 years. Hip fractures were twice as prevalent in females as in males and the incidence was found to double for each 5-year increment in age. The percentage of femoral neck fractures decreased with age in females but was constant in males.

A case of adenomatoid tumour with invasive growth of the testis is described. The clinical, pathologic, histologic, histogenetic and therapeutic aspects of this tumour are discussed with reference to the reported case and to the literature. It is important to establish the diagnosis of benign adenomatoid tumour, so that local excision can be performed instead of orchiectomy. Local excision usually is adequate, even when the tumour shows invasive growth.

A long term follow-up study of 518 patients with hip fractures was undertaken 2.5 years after the operation. The total mortality was 35 per cent (180/518). The risk of social deterioration for patients admitted from home was 47 per cent (132/281). A statistical analysis showed this risk to be determined primarily by the age of the patient and secondarily by the placement of the patient on discharge from hospital. A thorough description of these factors is presented.

A survey was made of 1592 patients, over the age of 50 years, who had sustained a fracture of the hip. The mean age was found to be 77 years, and 76.9 per cent (1224/1592) of the patients were women. Trochanteric fractures accounted for 52.5 per cent (836/1592) of the cases and these patients had a higher mean age than those with femoral neck fractures. The average hospitalization time was 24 days and the mortality during the hospital stay was 8.6 per cent (137/1592). Statistical analysis revealed that the hospital mortality rate was related exclusively to the age and the sex. The mortality after 3 months was 17 per cent and that after 6 months 21.5 per cent. The survival rates paralleled the expected rate after 1.6 years but were found to be higher than expected after 2.8 years. The mortality after 1 year was 27 per cent, after 3 years 43 per cent and after 5 years 56 per cent.