Spasm or contracture of the gastrocnemius muscle is predominantly responsible for the equinus deformity of the
1. The results of thirty-nine operations for correction of drop-foot in thirty-three patients with leprosy are discussed. 2. The procedure used was circumtibial, subcutaneous, two-tailed, tendon-to-tendon transfer of the tibialis posterior to extensor hallucis longus and to extensor digitorum longus and peroneus tertius. The motor slips were inserted into the recipient tendons on the dorsum of the
Over a period of one year we treated nine fractures of the sesamoid bones of the hallux, five of which were in the medial sesamoid. All patients had symptoms on exercise, but only one had a recent history of injury. The mean age of the patients was 27 years (17 to 45) and there were six men. The mean duration of symptoms was nine months (1.5 to 48). The diagnosis was based on clinical and radiological investigations. We describe a new surgical technique for percutaneous screw fixation for these fractures using a Barouk screw. All the patients were assessed before and after surgery using the American Orthopaedic
In a retrospective study we compared the results of 31 Wilson and 31 Hohmann osteotomies of the first metatarsal in the treatment of hallux valgus. There were no differences between the two operations in terms of patient satisfaction, pain relief, appearance, footwear and walking ability. First metatarsal shortening was the same after both operations, and the degree of shortening was unrelated to either the clinical or the pedobarographic findings. Although the long-term radiographic changes after the Hohmann osteotomy were more worrying, the pedobarographic patterns tended to be worse after the Wilson osteotomy. There were no poor results and the numbers of feet with the same final grade were identical in each group. However, there was abnormal loading of the lateral metatarsal heads after both osteotomies when compared with the normal
1. It has been shown in fifty normal feet that the perpendicular static plantar pressures rise by about 35 per cent between the ages of five years and maturity. 2. It is very likely that similar increases in plantar pressures occur between two and five years of age. 3. The plantar pressures in seventy-eight feet of children with spina bifida were with a few exceptions substantially higher than those of normal children of the same age. It is likely that this is so, at least in part, because the feet of children with spina bifida are smaller than normal. 4. This increase in perpendicular static pressure during growth must be relevant in the production of trophic
One hundred cases of Lambrinudi's arthrodesis are reviewed. The shortest follow-up was one year. and the longest twenty-seven years. Thirty-seven per cent were successful. Nineteen per cent were failures; many of these were associated with faulty technique, and one method of operation which gives good results is described. Success is likely if there is a balance of power between the dorsiflexors and plantarflexors of the ankle, especially if there is some fixed equinus before operation. Success is less likely when the operation is done for a flail
Spondylolisthesis without a defect in the neural arch, the "pseudo-spondylolisthesis" of Junghanns, usually affects the fourth lumbar vertebra. The essential lesion is an increase in the angle between tile inferior facets and the pedicles which allows subluxation at the inferior joints. The forward displacement averages less than one centimetre. It commonly produces a clinical picture of backache and sciatica, but may present with. a "drop
The objective of this study was to compare early postoperative
functional outcomes and time to hospital discharge between conventional
jig-based total knee arthroplasty (TKA) and robotic-arm assisted
TKA. This prospective cohort study included 40 consecutive patients
undergoing conventional jig-based TKA followed by 40 consecutive
patients receiving robotic-arm assisted TKA. All surgical procedures
were performed by a single surgeon using the medial parapatellar
approach with identical implant designs and standardized postoperative inpatient
rehabilitation. Inpatient functional outcomes and time to hospital
discharge were collected in all study patients.Aims
Patients and Methods
The pathogenesis of intraneural ganglion cysts is controversial.
Recent reports in the literature described medial plantar intraneural
ganglion cysts (mIGC) with articular branches to subtalar joints.
The aim of the current study was to provide further support for
the principles underlying the articular theory, and to explain the
successes and failures of treatment of mICGs. Between 2006 and 2017, five patients with five mICGs were retrospectively
reviewed. There were five men with a mean age of 50.2 years (33
to 68) and a mean follow-up of 3.8 years (0.8 to 6). Case history,
physical examination, imaging, and intraoperative findings were
reviewed. The outcomes of interest were ultrasound and/or MRI features
of mICG, as well as the clinical outcomes.Aims
Patients and Methods
We describe the radiographic measurement of the angle of tilt of the patella and relate it to malalignment of the extensor mechanism. The tilt angle is defined as the angle subtended by a line joining the medial and lateral edges of the patella and the horizontal. The radiograph (Merchant type) is taken with the
Injury to the dorsomedial cutaneous nerve in the
Sixty patients each of whom had a fracture of the lower limb a minimum of five years (median 11 years) previously were studied by photoplethysmography,
To study the effect of ligament injuries and surgical repair we investigated the three-dimensional kinematics of the ankle joint complex and the talocrural and the subtalar joints in seven fresh-frozen lower legs before and after sectioning and reconstruction of the ligaments. A
We assessed peripheral nerve function during and after lower-limb lengthening by callotasis in 14 patients with short stature, using motor conduction studies. Four patients with short stature of varying aetiology showed unilateral and one showed bilateral weakness of
1. Forty-eight cases of causalgia are reviewed and the clinical features are briefly described. 2. Multiple nerve injuries are common and the pain is often associated with all the injured nerves. In the upper limb there was always an incomplete lesion of the lower trunk or medial cord of the brachial plexus, or of the median nerve. In the lower limb there was always an incomplete lesion of the medial popliteal division of the sciatic, the medial popliteal, or the posterior tibial nerve. These nerves carry most of the sympathetic fibres to the hand and
1. A series of cases of Morton's metatarsalgia is reported in which twenty-seven selected patients have had thirty-five operations on the sole of the
We studied perioperative pain and postoperative neurological changes after surgery for hallux valgus in 50 patients operated on under local ankle block. Patients were randomised to have the pneumatic tourniquet either at calf level or just above the ankle. The cuffs were inflated to 100 mmHg above systolic blood pressure. One patient was withdrawn from the study after randomisation. Areas of pain, paraesthesia and numbness were marked by patients on a diagram of the
We reviewed 20 patients with spina bifida who had had surgical management of tibial torsion. Eight had had bilateral procedures and 12 a unilateral procedure, giving a total of 28 limbs for analysis. We performed closed osteoclasis on seven limbs and tibial osteotomy on 21. In the closed osteoclasis group six limbs (85%) had a good result after an average follow-up of nine years (2 to 22). All limbs developed postoperative anteromedial bowing of the tibia which later remodelled. In the tibial osteotomy group 19 (90%) had a good result. The average follow-up was nine years (2 to 28). Complications occurred in seven limbs (33%). We recommend closed osteoclasis of the tibia for the young patient with spina bifida in whom walking is impeded by excessive internal tibial torsion, and supramalleolar tibial osteotomy in the older patient with excessive external tibial torsion and a planovalgus
Since 1986, we have treated displaced intra-articular fractures of the calcaneum by open reduction through a lateral approach, stable internal fixation and bone grafting. We assessed the results at a mean follow-up of 2.92 years in 44 patients, comparing them with those for 19 patients treated non-operatively. Clinical assessment used the scoring system of Crosby and Fitzgibbons (1990) and radiological measurements were made from lateral, axial and internal oblique views. The articular congruity of the subtalar joint and any arthritic changes were also assessed. We found significantly better results in the operated group with respect to pain, activity, range of movement, return to work and swelling of the hind