Introduction: Primary fixation of displaced sub-capital fractures with low morbidity and low mortality offers an approach to a very common problem. The vast majority of patients receiving this form of treatment will not require further surgery. When confronting with the problem of primary arthroplasty which includes a higher morbidity and higher mortality, a higher infection rate and the possibility of prosthetic loosening especially in young patients, the choice seems clear.

Material and method: Between 1995 and 2000, a series of 21 patients (15f, 6m) were admitted for a displaced subcapital fracture (16 type Garden III, 5 type Garden IV) to our clinic. All the patients were operated 24 to 36 h after admission.

The mean age was 48y. The technique consists of:

Anatomic reduction (with a C-arm), which was the most crucial point of the technique.

Results: The mean follow-up was 34 m. We did not have any osteonecrosis of the head. No complications. The mobility of the hip was normal in all patients. There were two cases with delayed union and one case with non-union due to a distention at the site of the fracture after the reduction_

Conclusion: We believe that this technique, especially the combination of an anatomic reduction of the fracture and the use of a cancelocortical graft is a very prospective alternative to a prosthetic replacement in relatively young patients.

Introduction: The acute rupture of Achilles tendon is injury with absolute indication for operation. Rupture of the Achilles tendon is only in rare instances due exclusively to an accident. Commonly, the site of rupture reveals marked fraying and degenerative lesions.

Therefore, the pathologic tissue must be excised and often a large defect is created. Different procedures have been described to repair this defect.

Methods: In our department, between June 1995–June 1997 we have use the operation described by Lange to bridge the defect in 15 acute rupture of Achilles tendon.

This procedure consists in turning down a fascia flap from the gastroknernius to bridge the gap and end-to-end suture. In 13 patients the plantaris tendon has been used as a reinforcing membrane. In 2 cases we didn’t found it. We didn’t have any postoperative complications. After care a long -leg cast is applied with sufficient equinus of the foot and flexion of the knee for 6 weeks. For 6 weeks more a short leg cast was applied with the foot in neutral position and weight hearing was slowly resumed.

Results: All the patients were reviewed between 6m and 2y. (F.U. 14m) and pain, range of motion, power, and functional level were evaluated.

We had 2 far results and 1 poor but -no rerupture. The gap that we were obliged to repair was between 3cm–8cm

Discussion: We believe that this procedure, described for neglected rupture, is a method that we can recommend for acute rupture of degenerative Achilles tendon.