The hypothesis that the chronic tennis-elbow syndrome is caused by an entrapment neuropathy of the radial nerve (Roles and Maudsley 1972) was put to the test prospectively in ten patients. Detailed orthopaedic, neurological and neurophysiological examinations did not reveal any involvement of the radial nerve. It is concluded that this syndrome cannot be explained by an entrapment neuropathy

Mechanical derangements of the knee are an uncommon complication of chronic haemophiliac arthropathy. Two patients with locking of the patella were treated by manipulation. The mechanism of the injury was forced flexion of the knee joint beyond the limit of its restricted range. The injury is a serious one and may take six months to recover

Simultaneous bilateral posterior dislocation of the hip is very uncommon and most cases are caused by road accidents. Simultaneous bilateral posterior dislocation of the hip due to convulsions is extremely rare. We report the case of a man who was diagnosed late and operated on 15 weeks after the injury. We discuss the treatment of chronic dislocation of the hip and review the literature

Aspergillus infection of the spine is rare; for it to lead to paraplegia is still more rare. When this does occur it is usually treated by decompression and antifungal agents, but the results have usually been poor. We report two cases of successful conservative treatment of Aspergillus paraplegia in patients with chronic granulomatous disease

We describe the clinical features of calcifying tendonitis in the medial head of gastrocnemius in three elderly female patients. The presenting symptom was chronic pain in the posteromedial area of the knee in two patients and acute pain in the back of the knee in one. All had limitation of movement of the knee and marked tenderness in the region of the tendinous origin of the medial head of gastrocnemius with posterior knee pain induced by stretching the tendon. An injection of 1% lidocaine and steroid into the tendon resulted in temporary relief from pain and improved movement

1. Exercise ischaemia in athletes with chronic pain over the postero-medial border of the tibia is described. 2. Fasciotomy of the compartment of the deep flexor muscles as a treatment of "shin splints" is recommended. 3. In eleven patients the symptoms were completely relieved and the athletes were able to start effective training within four weeks

Eight cases of carpal tunnel syndrome are reported, all of which developed in patients on haemodialysis for chronic renal failure. In each case the arm involved had been used for a fistula. The aetiology of the syndrome in these patients is discussed; it is multifactorial, but related to the sites of arteriovenous fistulae. Decompressing the carpal tunnel provides effective and lasting relief

1. Cases are presented to show that blackthorn inflammation is not uncommon in the West Midlands. 2. The pathology is that of a chronic non-suppurative inflammation. 3. Cases are divisible into three groups on the basis of their history. In the third group, with no history of blackthorn trauma, diagnosis may be very difficult. 4. Removal of the blackthorn fragments causes prompt resolution of the inflammation

Nineteen patients with chronic pain due to a traumatic peripheral neuropathy were treated by means of implanted nerve stimulation. In 11 (58%) pain was completely relieved and in four (21%) it was reduced sufficiently to discontinue analgesics. The average follow-up was 11.5 months. The technique is described and the failures discussed. The necessity for implanting the stimulator proximally is emphasised

1. Six cases of infection of wounds with actinomyces are described alld tile cultural characteristics of tile organisms are discussed. 2. In three patients the infecting organism was an unusual aerobic form. 3. Possible sources of infection are considered. 4. The chronicity of the condition and the difficulty in treatment are stressed. 5. Penicillin and X-radiation hold out most hope of cure

Aims

Adductor canal block (ACB) has emerged as an alternative to femoral nerve block (FNB) for analgesia after total knee arthroplasty (TKA). The optimal duration of maintenance of the ACB is still questionable. The purpose of this study was to compare the analgesic benefits and physiotherapy (PT) outcomes of single-shot ACB to two different regimens of infusion of the continuous ACB, 24-hour and 48-hour infusion.

Aims

The glenohumeral joint is the most frequently dislocated articulation, but possibly due to the lower prevalence of posterior shoulder dislocations, approximately 50% to 79% of posterior glenohumeral dislocations are missed at initial presentation. The aim of this study was to systematically evaluate the most recent evidence involving the aetiology of posterior glenohumeral dislocations, as well as the diagnosis and treatment.

Displaced fractures of the os calcis involving the subtalar joint frequently cause chronic disability due to subsequent osteoarthritis. Early posterior subtalar fusion may prevent this outcome. We have reviewed forty-seven fractures in forty-three patients at an average of seven years after operation. Over 90 per cent of patients had an excellent, good or satisfactory result

Two cases of skeletal amyloidosis are described. In one the disease existed for many years, progressively destroying several vertebral bodies. There was no evidence of chronic infection, myelomatosis or cancer. In the other case myelomatosis was the primary disease but the first manifestation was a cystic tumour of the humerus. Not until several years later did typical bone lesions and Bence-Jones protein reveal the true nature of the disease

We have used a modified technique of cervical osteotomy to treat a consecutive series of 23 patients with chronic slip of the upper femoral epiphysis. It has been successful in correcting both moderate and severe deformities with a low incidence of avascular necrosis, comparable to that seen after subtrochanteric osteotomies. We describe the operative details and discuss the features which make cervical osteotomy technically superior to intertrochanteric and subtrochanteric procedures

We report three cases of avulsion of the ischial tuberosity with marked chronic disability after delay in diagnosis and non-union of the fracture. All were treated by open reduction and internal fixation with return to full function, allowing in one case, athletic performances of Olympic standard. We also report one patient with an acute apophyseal avulsion treated by early reduction and internal fixation with restoration of full function

1. The venographic findings in clinical primary osteoarthritis are described. 2. Experimental venous engorgement, of the knee joint and of healing fibular fractures, results in accelerated bone formation and disturbed cartilage formation. 3. Changes in pH, ppCO. 2. , and PPO. 2. are indicated as the chemical means by which chondrogenesis and osteogenesis can be altered. 4. It is suggested that chronic venous stress in joints is a causal factor in primary osteoarthritis

1. Transient synovitis is an acute, and at times exudative, condition of the synovial membrane. 2. There is no particular association with injury or with upper respiratory infection. 3. The course is short and benign with complete resolution. The occasional hip with chronic or recurrent symptoms can be distinguished from Legg-Perthes' disease by the shorter history, normal radiographs and the complete resolution. 4. There is no evidence that transient synovitis leads to avascular changes in the femoral head

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 foot