Aims

Accurate measurement of the glenoid version is important in performing total shoulder arthroplasty (TSA). Our aim was to evaluate the Ellipse method, which involves formally defining the vertical mid-point of the glenoid prior to measuring the glenoid version and comparing it with the ‘classic’ Friedman method.

The collagen framework of articular cartilage is disposed, as in other connective tissues, to resist tension forces within the material. In this paper the fine structure of articular cartilage, as demonstrated by polarised light microscopy and electron microscopy, is related to the gross anatomy and to the naked eye changes of chondromalacia and fibrillation

1. An attempt has been made to correlate the radiographic appearances and the morbid anatomy of the cystic changes that occur in the head of the femur in advanced osteoarthritis. 2. The suggestion is made that these lesions are foci of traumatic bone necrosis. Repair may be complicated by the subsequent entrance of synovial fluid through defects in the surface

Four cases are shown to illustrate remodelling of the lower end of the humerus after supracondylar fractures with displacement in childhood. Remodelling is rapid and will restore almost normal anatomy and good function even with severely displaced fractures. The results are much better than in many cases treated by open reduction

We investigated the relationship of the inferior gluteal nerve to gluteus maximus by dissecting the muscle in 12 fresh-frozen and formalin-treated cadavers. The anatomy was recorded using still digital photography. The course of the inferior gluteal nerve was carefully traced and was noted to enter the deep surface of gluteus maximus approximately 5 cm from the tip of the greater trochanter of the femur. The susceptibility of the nerve to injury during a posterior approach to the hip may be explained by its close relationship to the deep surface of gluteus maximus. It is easily damaged before it has been seen if the muscle is split and parted more than 5 cm from the tip of the greater trochanter of the femur. We suggest that a modified posterior approach be used to expose the hip to avoid damage to this nerve

1. A case of total dislocation of the cuboid bone without fracture is described. This is an uncommon injury and to our knowledge has not previously been reported. 2. Its rarity is explained in the light of the structural anatomy and function of the foot. 3. A mechanism of injury is postulated and a method of reduction and fixation described

1. The movements of the talus are described with particular reference to the anatomy of congenital talipes equinovarus. 2. It is suggested that the fundamental deformity in severe club foot is the fixed plantar-flexion of the talus. 3. Early operation is advised whenever serial stretching fails to bring the heel quickly into its normal position

The microvascular anatomy of the calcaneal tendon was investigated in cadaver tendons by injection of barium sulphate and indian ink and a quantitative study of intratendinous blood supply was made, using a computer-assisted image analysis system. There was a reduction in both the number and the mean relative area of vessels in the mid-section of the tendon. This area of reduced vascularity may be of significance in the pathogenesis of rupture

1. Chondromalacia of the patella starts most frequently on the medial facet. 2. The anatomy of the medial femoral condyle is described, including the rim at its superior border, and the different arrangement at the upper border of the lateral femoral condyle. 3. Rubbing of the medial patellar facet on the rim at the upper border of the medial femoral condyle can explain in part the etiology of chondromalacia

1. A case of traumatic aneurysm in the popliteal fossa after a lateral meniscectomy is described. 2. Relevant factors in the surgical anatomy of the inferior genicular artery are discussed. 3. The value and limitations of angiography of the popliteal artery are considered. 4. Treatment is governed by the degree of involvement of the popliteal artery. In the case described cure of the aneurysm was obtained by endo-aneurysmorrhaphy

We performed MRI on 13 infants after operative reduction for developmental dysplasia of the hip (DDH). Using an axial gradient-echo sequence, MRI accurately depicted the acetabular anatomy and confirmed adequate reduction in 12 patients. The one patient with redislocation after surgery was correctly identified. MRI can be carried out quickly, inexpensively and without risk of radiation and is the investigation of choice to confirm adequate reduction in DDH

Exposure of the prosthesis is one of the problems encountered after arthroplasty of the knee. Eight patients with nine exposed prostheses have been treated by using a gastrocnemius myocutaneous flap to provide cover. This preserved the prosthesis and closed the joint in six of the eight patients.l The factors leading to breakdown of the wound are discussed and the anatomy of the gastrocnemius myocutaneous flap and the operative procedure are described

1. Dislocation or sublaxation of the inferior radio-ulnar joint in association with fractures of the head of radius is discussed. 2. The incidence of the complication is greater than is generally supposed, and figures are given to support this finding. 3. The subluxation is not always associated with symptoms, and the degree of displacement may not be sufficient to be recognised clinically. 4. The anatomy and mechanism of the displacement have been investigated experimentally, and the results of the experiments are described

Isolated traumatic dislocation of the radial head in children is not as rare as sometimes supposed. Attention to detail in radiographic interpretation is the key to diagnosis. Early closed reduction and immobilisation in an above-elbow plaster in 90 degrees of flexion and full supination for three to six weeks is recommended. Seven cases are presented, two of which were treated operatively and had unsatisfactory results. The applied anatomy, management and complications are discussed

Aims

To investigate the benefits of denosumab in combination with nerve-sparing surgery for treatment of sacral giant cell tumours (GCTs).

We describe three patients with a compartment syndrome of the thigh, two after total hip replacement and one after total knee replacement. Two of the patients were fully anticoagulated. A compartment syndrome of the thigh is a rare, but important complication of joint replacement surgery if patients are receiving anticoagulants. Close observation is needed and when indicated monitoring of the intracompartmental pressure should be done. Early recognition of the signs and symptoms of an acute compartment syndrome and knowledge of the anatomy of the compartments of the thigh will help in the diagnosis and treatment of this potentially devastating complication

1. A detailed analysis of the anatomy of spondylolisthesis reveals many causes of serious interference with the nerve roots. 2. These anatomical findings can be correlated with the symptoms. 3. In association with spondylolisthesis, cases of disc prolapse, tuberculosis, and a cauda equina lesion are described. 4. Adequate decompression of the affected nerve root is essential in all cases with sciatica. The operative procedure is described. 5. The problem of arthrodesis will be discussed fully in a separate paper

The use of an osteocutaneous free fibular graft as a single-stage reconstructive procedure for composite tissue loss is increasingly common. Detailed anatomical study in cadavers of the blood supply to the graft demonstrates cutaneous arteries arising from the peroneal artery and then passing along the posterior surface of the lateral intermuscular septum. These vessels pierce the crural fascia and then ramify to supply the skin. Knowledge of the vascular anatomy of the skin overlying the fibula is essential to the success of the graft

We report the use of a new approach for elbow arthroplasty in 58 cases over a 20-year period. A wide exposure, obtained by elevating the triceps attachment and dividing the radial collateral ligament, allows the excision of diseased tissue, articular irregularities and osteophytes. Normal anatomy is restored and active mobilisation can be started 10 days after operation. Good or fair results, with over 70 degrees of joint movement, were achieved in 88% of cases