We reviewed 96 consecutive cementless total hip replacements with four different designs; 21 PCA, 25 Harris Galante Porous/Harris Galante I (stem/cup), 25 Profile Porocoat/Tri-Lock Plus (stem/cup) and 25 Profile HA-coated/Tri-Lock Plus (stem/cup). The operations were performed in the period 1984 to 1991. Median follow-up ranged from 12 to 16 years in the four groups. Mean linear wear rates ranged from 0,17 to 0,21 mm/year in the four groups, and there were no statistically significant differences between the groups (p=0,9). Moderate or extensive osteolysis was found in 46 of the 96 included hips. The association between wear and extent of osteolysis was statistically significant (p=0,006). We found poor twelve-year survival of the primary prostheses in all four groups (50–70%), mainly due to revisions because of wear of the polyethylene liner and/or osteolysis. The sparsely documented Profile/Tri-Lock Plus systems did not perform statistically significantly better than the PCA and the HG. The poor long term results with these uncemented total hip arthroplasties illustrate the necessity of regular radiographic evaluation in order to detect osteolysis and liner-failure which both generally are asymptomatic until catastrophic failure appears.

1. Seventy-five patients sustained fractures of the pelvis with associated soft-tissue complications. Twenty died, and of these, thirteen died within forty-eight hours of admission to hospital.

2. The initial resuscitation and clinical assessment of these patients are discussed, and attention is drawn to the significance of the concomitant retroperitoneal haematoma as a cause of oligaemic shock, and as a dissembler of internal visceral injury.

3. The morphological fracture patterns are classified into six categories, but the fracture patterns are not correlated with specific visceral injuries.

4. Forty-six patients sustained urinary tract injuries. Of these, nineteen had suffered rupture of the urethra; fourteen had rupture of the bladder; two had both urethral and vesical disruption, and one patient had a torn ureter. The diagnosis and management of these injuries is discussed.

5. Twelve patients had a traumatic laceration or perforation of the ano-rectum. Nine of these patients had associated urethral or vesical injuries.

6. Four patients were involved in accidents and sustained pelvic fractures while in the last three months of pregnancy. The tragic outcome of this combination of circumstances is noted.

7. Attention is drawn to peripheral nerve injuries in association with pelvic fractures, and the difficulty of localising these lesions is stressed.

8. Eight instances of damage to the abdominal parietes are recorded. Four patients suffered skin and soft-tissue loss, two patients had diaphragmatic disruptions and two patients had abdominal wall dehiscences.

9. Major accident victims frequently have multiple injuries. This series of patients has been analysed to draw attention to the association of pelvic fractures with bizarre visceral injuries.