A case of bilateral congenital pseudarthrosis of the olecranon is described. The clinical features, radiological appearance and prognosis are distinct from the type of congenital pseudarthrosis of the forearm reported previously. The lesion appeared to be a localised failure of ossification within the proximal ulnar metaphysis. Excision, stabilisation and bone grafting led to rapid fusion

Arthrodesis of the knee is sometimes needed for failed total knee replacement, but fusion can be difficult to obtain. We describe a method of arthrodesis that uses the simple, inexpensive, Portsmouth external fixator. Bony union was obtained in all six patients treated with this technique. These results are compared with those obtained by other methods of arthrodesis

Six patients, aged between 3 and 51 years, with tuberculosis of the upper cervical spine were studied. Prominent features of the disease included pain and stiffness, paralysis, swelling of the retropharyngeal soft tissue, osteolytic erosions, and atlanto-axial subluxation. Cure was obtained with antibiotics, transoral decompression and C1-2 fusion

We performed arthrodesis of the ankle in eight patients by arthroscopic joint excision and fixation with crossed tibiotalar compression screws. Two patients had rheumatoid arthritis and six had post-traumatic osteoarthritis. None had a serious deformity of the ankle. Clinical ankylosis was achieved in all cases and there was radiological evidence of bone fusion in four

We report three patients in whom a fractured odontoid process was associated with a fracture of the superior articular process of the second cervical vertebra. Although there were no signs of neurological disorder, damage to the C1-C2 joint in all three patients made fusion necessary. Forced lateral flexion is suggested as the possible mechanism of injury

We report four cases of fracture of the cuboid treated by open reduction, bone grafting where necessary and internal fixation. We recommend this treatment where there is appreciable displacement of one or more of the articular surfaces. The preliminary results were better than those previously reported for conservative treatment or for later midtarsal fusion

A new technique is described for extra-articular subtalar arthrodesis; it combines the main elements of the Batchelor and the Grice procedures. Results were reviewed after a minimum of three years. Of the 25 feet treated 24 had solid fusion and had maintained the operative correction of the valgus deformity; the one non-union was due to deep infection

Sprain of the pisiform triquetral joint is a definite clinical entity. It presents as a "tenosynovitis" of the flexor carpi ulnaris muscle from which it can be distinguished by the tests described. The disability in most cases is such that operation is justifiable. Fusion of the pisiform-triquetral joint is preferred to excision of the pisiform because it restores stability to the wrist with the least disturbance to related structures

We present a case of Mycobacterium avium-intracellulare (MAI) infection of the ankle joint in a patient with HIV infection. The patient presented with a painful, destructive arthropathy of the ankle. Initial microbiological studies were negative but infection with MAI was later identified from biopsies taken during hindfoot fusion. Antibiotic triple therapy was given and the patient remains pain-free without evidence of active infection. To our knowledge, this is the first case of MAI infection of the ankle reported in the literature. A high index of suspicion of (atypical) Mycobacterial infection should be maintained in patients with HIV infection presenting with an indolent but destructive arthropathy of the ankle joint

1. A simple cone arthrodesis of the metatarso-phalangeal joint of the big toe based on the Rose and Mann operations is described. 2. New instruments have been devised to simplify the procedure. 3. Thirty-one operations have been performed on twenty-three patients. Bony fusion has occurred in all but one case. There have been no complications

Certain features of the sagging rope sign recently analysed by Apley and Weintroub (1981) are examined in detail. Evidence is presented to show that the line is a radiological shadow cast by the lateral edge of a severely deformed femoral head rather than a condensation of the spongiosa within the neck. An explanation is offered to explain the common association of the presence of this radiological sign with premature epiphysial fusion

A method of triple arthrodesis is described which involves inlay of the subtalar and midtarsal joints. It is applicable to the undeformed and valgus foot as is encountered in poliomyelitis, spasmodic flat foot, cerebral palsy and spina bifida. The operation was successful in controlling deformity and pain. The only significant complication was failure of fusion of the midtarsal joint which occurred in three of eighty-five feet (3-5%)

The technique described aims to eliminate the drawbacks of the commonly accepted operative procedures for correction of the spastic "thumb-in-palm" deformity without fusion of the thumb. In all seven patients followed up for one and a half to two years after operation the thumb regained a functional position, being held out of the palm together with the metacarpal without hyperextension of the metacarpo-phalangeal joint

The operation of soft-tissue release and calcaneocuboid fusion, published by Dillwyn Evans in 1961, is described in detail and a long-term review of 118 club feet is presented. The average age of the patients at review was nearly seventeen years. All were resistant cases and in all the Dillwyn Evans "collateral operation", deliberately delayed by a policy of prolonged conservative treatment, had been the main surgical procedure

In our practice sequestration of the shafts of long bones in children because of acute osteomyelitis continues to be a problem. Conventional procedures for bone grafting are likely to fail. Vascularised grafts with microvascular anastomosis are technically demanding with a high rate of failure. Transfer of the rib on its vascular pedicle to achieve anterior fusion in the thoracic spine is now well established and the length of the pedicle available is adequate to allow grafting of a diaphyseal defect in the humerus. We describe the successful use of this procedure in two patients

Aims

Magnetically controlled growing rod (MCGR) systems use non-invasive spinal lengthening for the surgical treatment of early-onset scoliosis (EOS). The primary aim of this study was to evaluate the performance of these devices in the prevention of progression of the deformity. A secondary aim was to record the rate of complications.

Eight women had 10 toes treated for hallux rigidus by dorsal wedge osteotomy of the proximal phalanx and were reviewed after an average follow-up of 22 years. Five toes were symptom-free, four others did not restrict walking, and only one had required metatarsophalangeal fusion. We conclude that dorsal wedge osteotomy affords long-lasting benefits for hallux rigidus in the adolescent female