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In the Innsbruck University Clinic for Traumatology during the years 1978-1985, altogether 17,999 patients received initial treatment for injuries incurred through Alpine skiing. 3240, or 18% of these injuries were trauma to the hand. The most frequently injured area was the thumb, with 1995, or 61.6% of the cases. The most common hand injury in skiing is the socalled "ski thumb", the lesion of the ulnar ligament of the metacarpal-phalangeal joint. Finger injuries accounted for 262 cases, or 8%. The capsule-ligament lesions predominated, especially the palmar capsule lesion of the proximal interphalangeal joint. The most common ligament lesion was the rupture of the radial collateral ligament of the metacarpal-phalangeal joint of the small finger. The metacarpal region was involved in 192 (6%) of the patients. The 4th and 5th metacarpal fractures were often combined with volar dislocation of the caput; the 2nd and 3rd metacarpals showed more often torsion fractures. Luxated fractures were found in all carpal-metacarpal joints. Carpal injuries were the least common, with 2.2%; the bony and ligamentous injuries in this region were, however, more serious. 40 scaphoid fractures were found, along with fractures of the triquetrum, trapezium, hamatum, and pisiform, as well as luxations and luxated carpus fractures. The injuries of the wrist are worthy of more attention. They include lesions of the distal radial-ulnar joint and distal radius fractures, and made up 22.2% of all hand injuries. More emphasis should be placed on diagnostic, therapeutic, and prophylactic measures for these injuries.

After massive hematemesis esophageal varices were found by radiography and endoscopy in a 79-year-old woman. Two episodes of bleeding could be stopped with the Sengstaken-Blakemore-tube. The patient, however, died after heavy vomitting of arterial blood, although the tube was in the proper position. Atopsy shows a fistula between a tractiondiverticulum of the esophagus and the aorta. A flaringup of an old tuberculosis, demonstrated by histology, caused the colliquating of the wall of the diverticulum and also the arrosion of the aorta.

Due to the advancement in the development of ski, technique, equipment and improvement of the slopes in the last decades, there has been a change in the type, form and location of fractures of the lower leg. In a 25 year follow-up at the department of traumatology of the University of Innsbruck we analysed the winter months of the year 1960/61, 1970/71, 1980/81 and the year 1984/85. A shifting of the localization of injuries towards the upper part of the body has been found. There is no doubt that because of the development of modern ski-bindings lower-leg fractures have decreased significantly with adults. At the age between 11 and 15 years there has been no proportional change in the frequency of injuries. The operative treatment has increased in number in comparison with the conservatively treated fractures.

Fractures at the distal end of the radius are the most frequent fractures. There are still many therapeutical problems. The success of conservative or operative treatment depends mainly on the different types of fractures. In order of compare end results and to recommend therapy, it is necessary to define different fracture types, based on practical classification. A classification of fractures at the distal end of the radius is presented, with localization and reference to the extent of injury with consideration of lesions of the radiocarpal joint and indirectly to the distal radio ulnar joint. In the period of growth five types of injuries are differentiated. In adults three main groups, depending on the involvement of the radio-carpal joint are described. These are subdivided according to dislocation. The fractures types were classified by using X-rays of cases over a period of several years. With this classification the pattern of injury of 593 fractures of the distal end to the radius, treated in 1980 in our clinic, was analysed.

This is an analysis of decline of rupture of the Achilles tendon in skiing while there is a steady increase of skiing injuries. Three groups, equipped with three different types of ski boots were observed once on a plane slope on the other hand on a bump track. The simultaneous size of angle of knee and ankle was measured by telemetry. The high plastic ski boot, which obstructs the ankle forward and lateral is apart from the rise of heel in the boot, the safety binding and the new skiing style the main reason for decline of rupture of the Achilles tendon in skiing.

The restitution of flexor tendon injuries of the hand according to the tissue-sparing method and functional follow-up treatment indicated by H. Kleinert and his collaborators has become very important in the acute treatment of fresh injuries of the hand. Having applied this method in the treatment of 176 patients suffering from 346 separated flexor tendons in 235 fingers, we are now able to present the limited indication. The surgical proceeding and the complications occurred are described, and the results found in the cases submitted to a follow-up examination (141 patients, 284 resutured flexor tendons in 194 fingers) are presented.

Immunohistochemical proof of A1FP production in the mammary gland of a man with gynecomastia is published here for the first time. The immunohistochemical proof of this fetal alpha-1-globulin in the intraductal epithelium of the mammary gland is described on the basis of the case history of a 25-year-old man with a metastasizing malignant teratoblastoma of the gonads. The question, to what extent A1FP-neosynthesis is characteristic for malignant tumors or whether it is a cellular response to specific, in this case hormonal growth stiumli of primary tumors, is also discussed.

Winter sport is of great importance in the Alpine countries. In 1980 3600 persons (10.24%) of all new admittances hospitalized in our hospital were injured when practicing winter sports. In 1983 they lessened to 2597 (7.73%) and in 1985 2999 (5.74%). Analysis of all injuries caused by winter sport activities shows that the number of injured persons is decreasing, severity of the injuries however, increasing. A comparison of the distal radius fractures in 1980, 1983 and 1985 indicates that extraarticular metaphyseal fracture types have decreased, intraarticular fracture with multiple fragments however, have increased. Mainly younger patient suffer from severe fractures. We regard the high pace-risk of the age group as the main course of this fact.