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The Proteus-syndrome is a recently described congenital hamartomatosis consisting of numerous clinical features of great variety. Mainly affected are the musculo-skeletal system, primarily by hemihypertrophy, macrodactyly and exostoses, and the skin and the subcutaneous tissue, primarily by pigmented naevi and subcutaneous tumors. The differential diagnosis includes other malformation syndromes, e. g. Klippel-Trenaunay-Weber syndrome and other hamartomatosis. Surgical intervention and treatment is difficult because of a frequency of complications and recurrences. This article describes clinical manifestations of Proteus syndrome, differential diagnosis and therapeutic strategies.

AIM Are autologous blood transfusions sufficient or do we need the transfusion of unwashed or washed wound drainage blood in total hip arthroplasty? METHOD 253 patients undergoing total hip arthroplasty were retrospectively randomized to autologous blood transfusion or transfusion of unwashed wound drainage. We compared the haemoglobin and haematocrit levels as well as the rate of complications. RESULTS Postoperative blood salvage and reinfusion after total hip joint arthroplasty didn't show any advantages. In 10 % we saw complications after transfusion of unwashed wound drainage. CONCLUSION We do not recommend the transfusion of wound drainage.

Purpose Presentation of the value of postsurgical computed tomography (CT) to diagnose loosening of uncemented femoral stems. Materials and methods Incremental CT and spiral CT were performed on six femora with implanted uncemented stems after the entire femora were embedded in polymethylmethacrylate. The femora were subsequently sectioned (thickness 1 mm, separation 8 mm) and the medial and lateral contact areas of the prosthetic stem compared with the CT data. Results The CT showed a contact of femoral stem and cortical bone between 0.4 mm (3.4 %) and 4.8 mm (47.1 %) and the section specimens between 0.9 mm (8.7 %) and 3.4 mm (36.7 %). No correlation was found between the results (r = 0.61), since the individual differences were up to 24 % in almost all sections. Conclusions Neither single-slice nor two-slice CT is capable of demonstrating the direct bone-endoprosthesis contact. Multidetector row CT (MDCT) is conceivably more accurate to measure the cortical contact of the femoral stem.