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Between 1972 and 1989 angulation osteotomy was performed on 61 patients with long humeral stumps at the Orthopaedic Hospital of Heidelberg University. Marquardt's surgical technique was used to improve function in patients who had undergone above-elbow amputation and in children with a risk of terminal osseous overgrowth. Thirty-one patients with 43 angulation osteotomies were followed up. Of the 10 adults followed up, the osteotomy had not straightened, whereas with the 33 angulation osteotomies in children, one had straightened out within 6 months, seven within 12 months and a further 12 up to 24 months after surgery. The only recognizable reason for this difference was the patient's age depending on whether humeral growth was not yet completed. Marquardt's angulation osteotomy, however, is still the only surgical technique that improves humeral stump function, providing a rotation-stable humeral prosthesis and a free-moving shoulder joint.

After undergoing an operation according to the Eden-Lange technique, 56 patients with recurrent anterior shoulder luxation were re-examined clinically at an average follow-up period of 20 years. The mean age of the patients at the time of the operation was 24.9 years; the ratio of male to female patients was 2.3:1. The Ellman score (maximum of 27 points), stability tests, reluxation rate and X-ray examinations served as re-examination criteria. The mean score for the Ellmann test was 18.3 points; 29 patients had ventral instability. In the meantime 11 shoulders had redislocated. Fifty-one patients had arthrotic alterations in the operated shoulder. Because of the unsatisfactory functional and radiographical results, the Eden-Lange technique can no longer be accepted as the only treatment of choice for anterior shoulder dislocation.

Three-dimensional imaging of hip joint preparations was carried out by means of computed tomography (CT). On the assumption that the head of the femur and acetabulum are incongruent, a special experimental design was used to quantify the extent and direction of the gliding movement of the head and socket. A series of CT images in the supine and prone positions was made from hip preparations, and the cartilage was visualized by injecting a contrast medium. In all the preparations dorsal movement was noted in the supine position, and ventral movement in the prone position. Cryomicrotome slices of the hip preparations were used to verify the results of our CT scans and the measurements correlated with the anatomical examinations. Thus, there is a certain amount of play in the hip joint-it is not an ideal ball-and-socket joint. This knowledge is important for the planing and success of hip adjustment surgery.

We report on a comparative anatomical investigation of hip joints from animals which can walk on two legs or use their distal legs for jumping. The investigation supports the results of Bläsius [1] that the hip is not congruent. The cartilage of the load induction area is thicker. This means that one can only see congruency on X-rays, because cartilage cannot be visualised.