A case of bilateral avascular necrosis of the capitate is presented. A review of the literature has identified a clear-cut clinical syndrome. The aetiology and pathology of this syndrome is discussed and a new method of treatment is proposed.
A review is presented of 508 feet in 310 patients after telescoping osteotomy of the lesser metatarsals for metatarsalgia. The patients were predominantly female (80%), with a mean age of 55 years; the range of follow-up was 1 to 12 years. In 22% of the patients the metatarsalgia was associated with rheumatoid arthritis. Improvements in assessment and modifications in technique are reported and the management of complications is discussed. The results show that telescoping osteotomy for established cases of pressure metatarsalgia is a simple and reliable operation. Permanent relief of symptoms can be expected in over 80% of patients.
An oblique osteotomy in the distal half of the metatarsal shaft is described for the treatment of metatarsalgia due to prolapse of one or more of the middle three metatarsal heads. Thirty-eight patients who have had this operation have been followed up for a period of from two to five years. The operation is simple, recovery is rapid and symptoms have been well relieved.
1. The venographic findings in clinical primary osteoarthritis are described. 2. Experimental venous engorgement, of the knee joint and of healing fibular fractures, results in accelerated bone formation and disturbed cartilage formation. 3. Changes in pH, ppCO2, and PPO2 are indicated as the chemical means by which chondrogenesis and osteogenesis can be altered. 4. It is suggested that chronic venous stress in joints is a causal factor in primary osteoarthritis.
1. The combination of femoral shaft fracture with dislocation of the hip in the same limb has been recorded in eighty-one patients since 1823. 2. A further fourteen cases are reported. 3. In over half the cases the hip dislocation was diagnosed late or not at all, and this error has occurred more often in modern times. The reasons for this are outlined. 4. The diagnostic physical signs of hip dislocation in the presence of a femoral shaft fracture are described. 5. The mechanism, sequels and treatment of this combined injury are discussed.
1. Three cases of fracture of the manubrium are described. 2. Two of these cases are very unusual in showing fracture of the manubrium caused by indirect violence. 3. The literature is reviewed and methods of treatment are discussed. 4. The mechanism of fracture of the sternum by indirect violence is discussed.
