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
With the aim of controlling pain after Keller's operation, a solution of a long-acting local anaesthetic was instilled into the field before closure in a series of thirty patients. In a controlled prospective trial this simple technique by itself proved to be significantly better than either
Three cases of a rare complication of Salter Type II fracture-separations of the distal tibial epiphysis are described. Interposition of the anterior tibial neurovascular bundle between the displaced epiphysis and the lower tibia prevented reduction and, in two patients, the blood supply to the
Flat
A new method for the measurement of tibial torsion using computerised transverse tomography is presented. Its accuracy is equal to that of cadaveric skeletal measurement. This method may be used in patients with unilateral post-traumatic torsional deformities, especially when these are combined with genu varum or valgum. The study of torsional aberrations in connection with congenital abnormalities of the
Radiographs of the
1. Dislocation and subluxation of the hip has been produced in young rats by application of splints reaching from the hip to the
Three cases of isolated anterior dislocation in the proximal tibiofibular joint are presented. The common aetiological feature was that injury occurred with the knee in hyperflexion and the
The aim of this study was to investigate the effect of a posterior
malleolar fragment (PMF), with <
25% ankle joint surface, on
pressure distribution and joint-stability. There is still little
scientific evidence available to advise on the size of PMF, which
is essential to provide treatment. To date, studies show inconsistent
results and recommendations for surgical treatment date from 1940. A total of 12 cadaveric ankles were assigned to two study groups.
A trimalleolar fracture was created, followed by open reduction
and internal fixation. PMF was fixed in Group I, but not in Group
II. Intra-articular pressure was measured and cyclic loading was
performed.Aims
Materials and Methods
Eight patients suffering from various forms of idiopathic dystonia are described whose initial referral was for an orthopaedic opinion. The diagnoses of these patients, who were seen over a two-year period, comprised dystonia musculorum deformans, dystonia of the
The aims of this study were to evaluate the efficacy of preoperative denosumab in achieving prospectively decided intention of therapy in operable giant cell tumour of bone (GCTB) patients, and to document local recurrence-free survival (LRFS). A total of 44 patients received preoperative denosumab: 22 to facilitate curettage, 16 to facilitate resection, and six with intent of converting resection to curettage. There were 26 male and 18 female patients. The mean age was 27 years (13 to 47).Aims
Patients and Methods
The traditional transosseus flexor hallucis longus (FHL) tendon
transfer for patients with Achilles tendinopathy requires two incisions
to harvest a long tendon graft. The use of a bio-tenodesis screw
enables a short graft to be used and is less invasive, but lacks
supporting evidence about its biomechanical behaviour. We aimed,
in this study, to compare the strength of the traditional transosseus
tendon-to-tendon fixation with tendon-to-bone fixation using a tenodesis
screw, in cyclical loading and ultimate load testing. Tendon grafts were undertaken in 24 paired lower-leg specimens
and randomly assigned in two groups using fixation with a transosseus
suture (suture group) or a tenodesis screw (screw group). The biomechanical
behaviour was evaluated using cyclical and ultimate loading tests.
The Student’s Aims
Materials and Methods
We used a high frequency response, ultra-thin transducer to measure forefoot pressures at predetermined sites on the sole of the
Three cases of the Nievergelt-Pearlman syndrome occurring in a family are presented. In addition to the major features of the syndrome (symphalangism, carpal fusion, atypical club
We suggest that, after an initial course of treatment in the accepted manner by gentle manipulations without anaesthetic, followed by splinting for a period of three or four months, the talo-calcaneal index should be measured on radiographs taken in the standard positions described. Should the correction be inadequate–that is, should the talo-calcaneal index be under 40 degrees even though clinically the
We treated 11 patients with chronic osteomyelitis of the tibia or the
The aim of this study was to evaluate health-related quality of life (HRQoL) and joint function in tenosynovial giant cell tumour (TGCT) patients before and after surgical treatment. This prospective cohort study run in two Dutch referral centres assessed patient-reported outcome measures (PROMs; 36-Item Short-Form Health Survey (SF-36), visual analogue scale (VAS) for pain, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)) in 359 consecutive patients with localized- and diffuse-type TGCT of large joints. Patients with recurrent disease (n = 121) and a wait-and-see policy (n = 32) were excluded. Collected data were analyzed at specified time intervals preoperatively (baseline) and/or postoperatively up to five years.Aims
Patients and Methods
Ten patients with Charcot-Marie-Tooth disease have been reviewed at an average of 14 years after soft tissue procedures to correct
We have treated 94 patients with chronic instability of the lateral side of the ankle by reconstruction of the ligaments with local periosteal tissue. We reviewed 90 cases after a mean follow-up of 2.8 years (2 to 9) using a questionnaire, clinical examination and radiography. The results on a 100-point ankle score indicated that 81% had a good or excellent result. The periosteal flap-replacement technique allows anatomical reconstruction and does not sacrifice other ligaments or tendons in the
In an attempt to improve the accuracy of diagnosis, 16 patients suffering from Morton's metatarsalgia were investigated clinically and electrophysiologically. The histological findings were related to these observations. The precise aetiology of Morton's metatarsalgia remains obscure, but the findings are compatible with an entrapment syndrome. Nerve conduction studies have a place in the investigation of patients with atypical presentation of pain in the