Two-nail fixation of the hip.

Osteoarthritis of the hip has a greatly varied incidence in different parts of the world. In Britain it has for many years presented one of the commonest and biggest problems in orthopaedic surgery-a problem which had shown little sign of solution until the introduction of intertrochanteric osteotomy by McMurray (1935). This operation entailed prolonged immobilisation, which excluded many elderly patients until the introduction of effective methods of internal fixation. More recently the total prosthesis, which may yet undergo many changes, has enabled us to deal remarkably effectively with the grossly damaged and distorted hip. In the face of two operations of such obvious value as these it is easy to forget older operations of proved worth. Pseudarthrosis as described by Girdlestone (1945) and modified by Batchelor (1945) and Milch (1948) will always remain as a stand-by and last resort. Arthrodesis has become an uncommon operation confined almost entirely to young people. Arthrodesis has been criticised on the grounds that it involves a prolonged period of