Bei Sportlern mit persistierender Metatarsalgie sollte an das Vorliegen eines Morbus Freiberg (Synonym: aseptische Nekrose der Mittelfußköpfchen Freiberg-Köhler II) gedacht und die entsprechende bildgebende Diagnostik veranlasst werden. Es wird eine Kasuistik mit verzögerter Diagnosestellung und operativer Behandlung geschildert. Obwohl die Ätiologie des Krankheitsbildes bisher unklar ist, ergibt eine frühzeitige Diagnose mit entsprechender Behandlung bessere Resultate als spätere Rückzugsoperationen.

Many persons with haemophilia suffer from HIV and receive highly active antiretroviral therapy. Three patients received indinavir and required surgery due to ingrown toenails. Two patients suffered from a traumatic subungual haematoma. The treatment protocol is described whereby the pressure exerted onto the germinal layer and the nail bed is relieved in order to alleviate pain and nail matrix damage.

Purpose : To determine the reason why 79% of knee disarticulation amputees had not received a prosthesis. Method : A 10 year survey was carried out of all patients who had undergone a knee disarticulation at our medical centre. Results : Seventeen of the 37 patients that had not received a prosthesis were recognized to be non-ambulators prior to the surgery. Four patients died after the surgery and in 16 of the patients their general condition limited functional ambulation. An effort had been made to ambulate the patients but had failed. Conclusions : From a biomechanical point of view many advantages are to be gained for sedentary and bedridden amputees when the level of amputation is through-the-knee.

A 52-year-old, trans-femoral amputee with haemophilia was hospitalized because of ambulatory problems arising from the osteo-arthropathic involvement of other major articulations. Reduced function in the upper limbs, caused by the effects of recurrent haemarthroses, resulted in additional problems concerning the usage of auxiliary ambulatory aids. The advantages and disadvantages of traditional and experimental crutches highlight the functional problems of ambulation in persons with concomitant upper limb pathologies.

Purpose : We report on cutaneous limb manifestations of Kaposi's sarcoma and the secondary infection of these lesions that necessitated five lower-limb amputations. Method : The cases are briefly described and prosthetic adaptations in respect to pressure, traction and sweating on the skin are considered. Results : All four patients ambulated initially; one lady died, the double amputee stopped walking owing to the excessive physical demand, and two patients ambulate freely. Conclusion : Special considerations to the cutaneous/prosthesis interface are necessary in order to provide these patients with optimal ambulatory ability.

A 51-year-old male required the construction of enormous custom-made shoes due to extreme lymphoedema. The lymphoedema developed as a late sequel of erysipelas. Aggressive conservative management of erysipelas and, if necessary, Charles operation should be considered in order to avoid the potentially catastrophic complications of this usually benign streptococcal infection.

The elbow joint is extremely prone to haemarthroses, and when these occur the elbow requires support and rest. Supporting the limb with a simple collar‐and‐cuff sling, a triangular bandage either with or without a shoulder immobilization device will provide an analgesic effect without adding an unnecessary heavy orthosis. As the swelling subsides and the pain lessens a dynamic orthosis aids in the support and compression. When considering functional bracing of the elbow joints there are a number of basic principles to be followed. One requires to consider problems of orthosis suspension, two dimensional motion and stabilization in the functional range of motion. This article provides the rationale for the special needs of persons with haemophilia who suffer from involvement of their elbow joints.

A case report is used as an example of how the will of a patient convinced an entire rehabilitation team to alter its assessment of the patient's ambulatory potential. The question of dual dynamics is discussed in the light of the realities of the honest desire and motivation to walk and regain independence.

The use of silicone inner sockets, with or without the incorporation of shuttle locks, has greatly improved the function of artificial limbs, They cushion and protect the stump and provide a means for prosthetic suspension, allowing more comfortable use, especially in patients with ischaemic stumps, They also allow greater movement at the proximal joint.