Aims: Evaluation of: 1/ type and incidence of pelvic ring injuries, 2/ type and incidence of associated injuries, 3/ type of pelvic ring injuries pathomechanism, 4/ influence of pelvic ring injuries on trauma severity score, 5/ analysis of clinical long term results.

Material and methods: Retrospective evaluation of 257 patients with pelvic ring injuries treated between 1989–2003 had been made. Mean patients age was: 65 y.o. (Range: 32–61 y.o.). Mean follow-up time: 57,5 months (range: 18–192 m.). All patients were treated no operatively: bed-rest, hamaque suspension, and skeletal traction. Analysis of pelvic injuries was made by Tiles classification. Evaluation of pelvic injuries pathomechanism was made by Young-Burgess classification. Clinical end results were evaluated by Iowa Pelvic Score. In polytraumatized patients trauma severity was evaluated by AIS and ISS.

Results: Incidence of pelvic injury in hospitalized patients was 1,3%. In study group there were following pelvic injury types: type A – 14 %, type B – 77 % and type C – 9%. Pathomechanisms of pelvic injuries in study group were following: type LC – 61%, type APC – 30%, type VS – 2%, type CMI – 7%. Long term clinical results in Iowa pelvic Score were for pelvic ring injuries: type A – 92 p., type B – 86 p., type C – 67 p. Mean value of ISS index in patients with pelvic ring injuries was 23p, mean value of ISS index in patients without pelvic ring injuries was 19p.

Conclusions: 1/ pelvic ring injuries in standard orthopedic and traumatic department are rare, 2/ pelvic ring injuries are frequent in polytraumatized patients, 3/ type C according to Tile’s classification is the most frequent type of pelvic ring injury, 4/ type LC according to Young-Burgess classification is the most frequent type of pelvic ring injury pathomechanism, 5/ incidence of pelvic ring injury in polytraumatized patient increases ISS index, 6/ long term clinical results suggested that most pelvic ring injuries can be successfully treated nonoperatively.

Aims: Evaluation of: 1/ early clinical and radiographic results of total hip arthroplasty (THA) made by standard lateral direct approach, 2/ early clinical and radiographic results of THA made by minimal lateral approach, 3/ comparison of results of THA in these two groups.

Material and methods: Prospective study of 120 THAs (60 cementless and 60 cement) done in 120 patients due to degenerative changes was made. 60 THAs made by minimal lateral approach consist study group. 60 THAs made by direct lateral approach consist of control group.

Mean age of 120 patients (98 women and 22 men) was 45 y.o. (range: 32–61 y.o.). Follow-up time in study group was from 6 to 12 months (mean: 8,5 months). Follow-up time in control group was from 10 to 16 months (mean: 10,5 months). Mean preoperative functional status of the study group was 44,5p in Harris hip score. Radiographic evaluation of the results was made according to criteria of Joined Committee of The Hip Society, AAOS and SICOT.

Results: Clinical results in 6 months after THA were: 92p. in study group and 88p. in control group. In all 120 cases in both groups radiographic results were very good – there were no differences between control and study group. Incidence of complications were similar in both groups.

Conclusions: THA with minimal invasive approach has proved its value in the treatment of hip degenerative changes as regarding short-time results. Clinical and radiographic results of THA made by standard or minimal invasive approaches are comparable. Successful THA with minimal invasive approach is a matter of excellent operative technique and experience with standard hip approaches, and not special instruments.

Aims: 1. Analysis of indications for THA in young adults with osteoarthrosis, 2. Evaluation of clinical and radiological end results, 3. Investigation of complications after metal-to-metal THA. Material: 75 THAs with metal-tometal cementless endoprosthesis in 75 patients which had been operated between 1997–2002 were retrospectively evaluated. There 50 women and 25 men (mean age: 39 years old). The mean time of follow-up was 2,8 years (form 6 to 48 months). Etiologic factors of osteo-arthrosis in operated hips were: idiopathic arthrosis in 50 hips, CHD in 18 hips, post-traumatic lesions in 3 hips, aseptic necrosis of the femoral capitis. Metal-to-metal THA with the cementless endoprosthesis was made in all evaluated cases with: Alloclassic systeml Ð 66, other systems Ð 9.Methods: The clinical evaluation was performed with Merle dñAbugine score. The radiological evaluation of THA was based on criterion proposed by joined committee of The Hip Society, SICOT and AAOS. Results: The mean postoperative clinical result in the study group is 5,5 p. in Merle dñAbugine score. Radiological result was very good in all hips. Conclusions: The study supports the satisfactory results of the THA with the metal-to-metal cementless endoprosthesis in reconstructive surgery of the hip with degenerative changes in young adults.