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Aim: The aim of this study to calculate the health insurance cost of treatment of patients with pertrochanter fracture of femur from the first hospital admission for 18 months follow up period according to different surgical methods and progressivity levels., Data and Methods: Recruitment criteria were: 1) all patients with a hip fracture in 2000 defined by the International Classification of Disease (ICD) as "S7210"; 2) working age between 18-60 and 3) first admission to surgical unit, and had an operation. The cost analyses include the cost of acute and chronic in-patient care, outpatient care and sick pay., Results: The total costs were the highest in case of those types of operations with lower cost of prothesis device and lower load stability (Ender 588.000 Ft, fix angled plate 534.000 Ft) because of the higher sick-pay costs. The total costs were the lowest in case of those types of operations with higher cost of prothesis device and higher load stability (Gamma 512.000 Ft, DHS 465.000 Ft) because of the lower sick-pay costs. The gain in recovery time with the 3-4 months shorter disability period can be seen in case of operations with higher load stability. The average length of stay decreases from 15-17 days to 9-11 along progressivity levels., Conclusion: With the application of load stable prothesis device the total health insurance costs were the lowest at the universities and national institute while these costs proved to be higher.

The review of the authors' 5 year material (from 1971 to 1975) showed 5 late latent septic complications. The average time in which septic signs became evident, was 7.7 months in their cases. Attention is drawn to certain inadequacies during operations, which may have a role in the aetiology of these infections, and to the importance of the correct assessment of the follow-up X-rays.

At the author's Department 70 infected osteosyntheses were treated. The preliminaries of infection were in 48 cases open, and in 22 cases closed fractures. The original stabilisation was performed in 48 injuried with plates, in 12 cases with intramedullary nails and in 10 other patients with various methods. In 12 cases healing of the infection was reached in a short time. In 58 cases the infection became chronic. In 34 cases the fractures healed in spite of persistant infection, in 24 cases infected pseudarthrosis developed. To reach healing or the definite state frequently more operations were needed. Finally it succeeded to heal both the infection and the fracture in 62 patients. Fistula, resistant to treatment remained in 7 patients.

After a chronological review the advantages of this method are reviewed here, together with the indications. The different types of fixator are demonstrated in some of their cases. It is emphasized, that this method is complementary to the internal fixation, and the indications of its use are made in an increasing number of cases, such as in septic complications as well as 3rd degree compound fractures, delayed unions etc.

The authors studied the diagnosis and treatment of posttraumatic infections of the hip joint, based on their own material. In case of latent infection the increased sedimentation rate and taking of comparative X-ray films are held important, that shows a narrowing and disappearance of the sclerosed edge of the acetabulum. Following dislocation of the hip joint ankylosis may be attained, but after fractures of the proximal and of the femur the infection cannot be cured, unless the nail and the head of the femur are removed.