[Postoperative infection of fractures of the upper end of the femur].

This series comprises 74 post-operative infections of fractures of the upper end of the femur, 47 associated with internal fixation and 27 with prostheses. The organisms were different in the 13 men, with a predominance of gram-positive cocci, from those in the 61 women in which the significantly high proportion of gram-negative organisms seemed to be due frequent to soiling of urinary origin. In the 47 internal fixations, local wound toilet gave 29 successful results with union in the normal time. Two patients were not able to be operated on again and died before they could be treated. Sixteen failures, including seven deaths, were due to septic arthritis of the hip. The diagnosis of septic arthritis was difficult, which explains why resection of the head and neck of femur was only made in six cases, five of them successfully. In the 27 prostheses, the best results were obtained by deep wound toilet retaining the prosthesis, with nine successes in ten cases. An acceptable functional result was compatible with a persistent grumbling infection.