1. A method of finger dissection is described which provides a new approach to the anatomical study of structures in close relation to joints. 2. The volar part of the capsule of the finger joints is described, the attachment to the bones being particularly emphasised together with its form which is like that of a meniscus. 3. A
A study of 79 children with malunion of forearm fractures is presented. Age at the time of injury, the site of the fracture and the degree and direction of angulation at union were correlated with loss of forearm rotation at review 3.5 to 6 years later. Some guidelines are proposed for the acceptability of angular deformity at union, importance being placed on the avoidance of radial deviation of the radius, and the maintenance of the interosseous
We treated 25 patients with severely deformed and shortened lower limbs by double oblique diaphyseal osteotomy of the short deformed bone, followed by balanced skeletal traction to correct the alignment and increase the length of the limb. The technique is simple and inexpensive and does not require special equipment. It has the advantage of allowing rapid lengthening and secure healing as the overlap allows end-to-end union with no bone
Our study evaluated the accuracy of an image-guided total knee replacement system based on CT with regard to preparation of the femoral and tibial bone using nine limbs from five cadavers. The accuracy was assessed by direct measurement using an extramedullary alignment rod without radiographs. The mean angular errors of the femur and tibia, which represent angular
Limb lengthening in nine patients was monitored by radiographs and by ultrasound scans. The distraction
There is little literature about total knee arthroplasty (TKA) after distal femoral osteotomy (DFO). Consequently, the purpose of this study was to analyze the outcomes of TKA after DFO, with particular emphasis on: survivorship free from aseptic loosening, revision, or any re-operation; complications; radiological results; and clinical outcome. We retrospectively reviewed 29 patients (17 women, 12 men) from our total joint registry who had undergone 31 cemented TKAs after a DFO between 2000 and 2012. Their mean age at TKA was 51 years (22 to 76) and their mean body mass index 32 kg/m2 (20 to 45). The mean time between DFO and TKA was ten years (2 to 20). The mean follow-up from TKA was ten years (2 to 16). The prostheses were posterior-stabilized in 77%, varus-valgus constraint (VVC) in 13%, and cruciate-retaining in 10%. While no patient had metaphyseal fixation (e.g. cones or sleeves), 16% needed a femoral stem.Aims
Patients and Methods
1. Three patients with enchondromata of the metacarpal bones are described. 2. The nature of the enchondromata in all three patients was confirmed by histological examination. 3. Treatment was by radical excision and bridging of the
Most of what I have said has been said before by various writers. Abduction osteotomy is the recognised form of treatment for developmental coxa vara. The results from this operation are usually good. But the results of treatment would probably be better if the condition could be diagnosed before deformity had become disabling, and if the
The treatment of acromioclavicular injuries is controversial; few studies document the late results. We have reviewed 53 patients about five years after conservative management, in nine for subluxation and 44 for dislocation. Subjective and objective results were satisfactory in all cases except for one with painful subluxation, who was the only patient to change her occupation because of the injury. At review, joint stability was demonstrated by improvement in position and by the very small increase in the coracoclavicular
Commonly performed unicompartmental knee arthroplasty (UKA) is not designed for the lateral compartment. Additionally, the anatomical medial and lateral tibial plateaus have asymmetrical geometries, with a slightly dished medial plateau and a convex lateral plateau. Therefore, this study aims to investigate the native knee kinematics with respect to the tibial insert design corresponding to the lateral femoral component. Subject-specific finite element models were developed with tibiofemoral (TF) and patellofemoral joints for one female and four male subjects. Three different TF conformity designs were applied. Flat, convex, and conforming tibial insert designs were applied to the identical femoral component. A deep knee bend was considered as the loading condition, and the kinematic preservation in the native knee was investigated.Aims
Methods
A consecutive series of 100 cases of wrist injury, other than those referred with a radial fracture, have been reviewed to determine the incidence of acute scapholunate instability; a "clenched fist" radiograph was used in addition to the routine scaphoid views. Of 19 patients with an increase in the scapholunate
The aim of this study was to examine trends in the management of fractures of the distal radius in Ireland over a ten-year period, and to determine if there were any changes in response to the English Distal Radius Acute Fracture Fixation Trial (DRAFFT). Data was grouped into annual intervals from 2008 to 2017. All adult inpatient episodes that involved emergency surgery for fractures of the distal radius were includedAims
Patients and Methods
The aim of this study was to evaluate the diagnostic accuracy of the synovial alpha-defensin enzyme-linked immunosorbent assay (ELISA) for the diagnosis of prosthetic joint infection (PJI) in the work-up prior to revision of total hip (THA) and knee arthroplasty (TKA). Inclusion criteria for this prospective cohort study were acute or chronic symptoms of the index joint without specific exclusion criteria. Synovial fluid aspirates of 202 patients were analyzed and semiquantitative laboratory alpha-defensin ELISA was performed. Final diagnosis of PJI was established by examination of samples obtained during revision surgery.Aims
Patients and Methods
Twenty-three adults with fractures of the odontoid process are reviewed. Te possible reasons for the high rate of non-union in reported series are considered: these include the type of fracture, its displacement, the presence of a
Eighty-two of 85 patients who had sustained a fracture of the waist of the scaphoid in 1985 were reviewed more than one year after injury. The incidence of nonunion, defined as a clear
We have studied the use of filamentous polyglycolic acid (Dexon) for the induction of neotendon in the calcaneal tendon of sheep. Uniformly good results were obtained, with the formation of a thick neotendon. However, in a control group the power of spontaneous regeneration of the tendon was studied; it was found that, provided overlengthening of the
Posterior dislocation of the acromioclavicular joint with the lateral end of the clavicle locked behind the acromion has only rarely been described. This paper present such a case diagnosed two weeks after the shoulder was injured in an accident. The clavicle was locked behind the articular surface of the acromion, restricting the movement of the shoulder and causing considerable pain. Anteroposterior radiographs showed a high-riding clavicle but no
Resection of the distal femur or proximal tibia en bloc has been performed on twenty-six patients with primary bone tumours. The