We present the results of a technique of dynamic hip screw insertion through a very small incision, typically 2.5cm.

Method: The technique is performed using a standard dynamic hip screw set and requires no additional equipment. We compared the results to those of an age and sex matched group who had undergone the operation through a traditional approach. We compared the time spent in theatre, the pre and post-operative haemoglobin concentration, haematocrit, and prevalence of wound infection.

Results: 13 consecutive intertrochanteric hip fractures were treated with a dynamic hip screw and 4-hole plate by one surgeon using the percutaneous technique. There were 9 females and 4 males with a mean age of 84 years (range 62 to 96 years).

The mean post-operative drop in haemoglobin concentration in the percutaneous group was 2.2 g/dl (range 0 to 4.4 g/dl) compared to 3.5 g/dl (range 1.2–5.4) in the control group (p=0.014). The mean haematocrit drop was 0.07 (range 0 to 0.12) in the percutaneous group compared to 0.10 (range 0.03 to 0.17) in the control group (p=0.017)

The mean theatre time with the percutaneous technique was 57 minutes (range 40–75 minutes) and in the control group, 60 minutes (range 30–95). There were no wound problems.

Conclusion: To our knowledge, this technique has not been previously reported. The percutaneous technique offers a better clinical outcome at no extra expense and warrants further evaluation in a larger study

Eleven patients with tears of the acetabular labrum are discussed and the syndrome of the torn labrum is defined. In all cases the lesion was associated with acetabular dysplasia, and a constant early radiological sign was a cyst in the lateral aspect of the acetabulum. The diagnosis was confirmed by arthrography. It is suggested that these tears are degenerative, occurring as a consequence of abnormal stresses imposed by the uncovered lateral portion of the femoral head. Once a tear is present a localised stress point occurs on the femoral head, leading rapidly to degenerative arthritis.