1. Forty-six cases of congenital spondylolisthesis (Newman's Group 1) have been studied. The diagnostic criteria were lumbo-sacral subluxation, deficient development of sacral neural arches and superior facets, and attenuation and elongation of the pars interarticularis, with or without a defect in continuity. 2. Intertransverse lumbo-sacral fusion is a safe and reliable method of treatment. 3. Stabilisation is not complete before two years. 4. Spinal fusion is indicated in all patients with significant symptoms during the period of growth, but in adult patients only if conservative treatment
1. Seventy-five injuries of the cervical spine are reported. Fifty-three were dislocations and fracture-dislocations involving the third to the seventh segments. 2. The importance of careful examination in all neck injuries is stressed. 3. The injuries are divided into stable and unstable types and the causation of the instability is discussed. 4. Plaster immobilisation for more than six months
1. It is suggested that slow recovery and post-operative effusion after meniscectomy may often be due to "scar friction" when the incision in the synovial membrane is in contact with the non-articular surface of the femoral condyle. 2. The advantages of a horizontal incision are discussed, particularly with regard to early recovery. 3. The results of one hundred and three cases of meniscectomy are analysed. An attempt to trace the cause of incompletely successful results in 25 per cent. of cases
Sickle-cell disease (SCD) is probably the commonest cause of avascular necrosis worldwide, and its prevalence appears to be rising in developed countries. Avascular necrosis of the humeral head is a common complication but has not been previously studied in detail. We have reviewed 138 patients with SCD for clinical, radiological and functional abnormalities of the shoulder, using a radiological classification designed for avascular necrosis of the shoulder. Radiographic lesions, frequently bilateral, were found in 28% and only 53% of patients had normal shoulder function. The management of this relatively common complication is difficult. Joint replacement is likely to
We treated 12 patients with multilevel stenosis of the cervical canal after spondylosis or ossification of the posterior longitudinal ligament by an expansive open-door laminoplasty, stabilised by using an anchor system. The preoperative sagittal diameter of the canal was 9.8 mm(±2.2) which was increased to 16.1 mm (±2.9) after surgery. The mean expansion ratio of the canal was 64% (42 to 100). The anchoring systems did not
The management of acetabular defects at the time of revision hip arthroplasty surgery is a challenge. This study presents the results of a long-term follow-up study of the use of irradiated allograft bone in acetabular reconstruction. Between 1990 and 2000, 123 hips in 110 patients underwent acetabular reconstruction for aseptic loosening, using impaction bone grafting with frozen, irradiated, and morsellized femoral heads and a cemented acetabular component. A total of 55 men and 55 women with a mean age of 64.3 years (26 to 97) at the time of revision surgery are included in this study.Aims
Patients and Methods
During a four-month period we observed 12 stress fractures of the inferior pubic ramus in 11 military recruits undergoing basic training. Eleven of these were in women. This high number was considered to be caused by the introduction of mixed training of male and female recruits; this forces women to increase their stride length when marching. The presenting symptom was chronic groin pain which
This paper reports a prospective study of the value of ultrasonography in detecting lesions of the lumbar spine in patients with compressive sciatica. The measurements of the diameter of the spinal canal obtained by using ultrasound were compared with the findings at operation in 17 patients in whom a total of 50 sites were examined. The ultrasound beam
The use of a total femoral prosthesis can offer a realistic alternative to amputation or disarticulation. The limited indications for such a prosthesis in the surgical management of primary bone tumours and pathological fractures still exist. In this specialised clinic there is an increased need to replace the entire femur where repeated procedures have
Seventy-five Freeman-Swanson (ICLH) Mark I total knee replacements, all performed in one orthopaedic unit between 1972 and 1975, were independently reviewed. The fifty-eight surviving patients, with sixty-eight arthroplasties, have been interviewed and examined and the clinical records of the deceased patients inspected. Sixty arthroplasties (80 per cent) were successful and fifteen
1. Forty-five cases of zoster paralysis, not involving the cranial nerves, are detailed. These include eighteen cases not previously published. Of these eighteen patients, one-third were referred for an orthopaedic opinion. 2. Complete or almost full recovery occurred within a year in two-thirds of the patients. Permanent paralysis occurred in one-sixth of the patients studied. 3. Muscles that
The follow-up of these seventy-three cases suggested the following conclusions:. 1. The clinical signs alone are not always sufficient to make the diagnosis of herniated nucleus pulposus with sufficient accuracy. 2. When positive, myelography was reliable as a means of localising the hernia. 3. In doubtful cases in which conservative treatment
1. A realignment operation is described for the treatment of recurrent dislocation of the patella. 2. In twenty-three patients (twenty-seven knees) operation prevented further dislocation. The physical and functional condition of the knees two to twenty years after operation is described. 3. Patello-femoral osteoarthritis was not a clinical complication in any of these patients. This finding is discussed. 4. Genu recurvatum developed in four patients operated upon between the ages of ten and thirteen years. The cause of this deformity is discussed. It is concluded that the realignment operation should not be performed under the age of fourteen years. 5. In three patients operation
Recurrent infection following two-stage revision total hip arthroplasty
(THA) for prosthetic joint infection (PJI) is a devastating complication.
The purpose of this study was to report the survival of repeat two-stage
revision hip arthroplasty, describe complications, and identify
risk factors for failure. We retrospectively identified 19 hips (19 patients) that had
undergone repeat two-stage revision THA for infection between 2000
to 2013. There were seven female patients (37%) and the mean age
was 60 years (30 to 85). Survival free from revision was assessed
via Kaplan–Meier analysis. The patients were classified according
to the Musculoskeletal Infection Society (MSIS) system, and risk
factors for failure were identified. Mean follow-up was four years
(2 to 11).Aims
Patients and Methods
Our previous reports on the pathological anatomy and operative treatment of intra-articular fractures of the calcaneum
We reviewed 38 patients who had been treated for anosteochondral defect of the talus by arthroscopic curettage and drilling. The indication for surgical treatment was persistent symptoms after conservative treatment for at least six months. A total of 22 patients had received primary surgical treatment (primary group) and 16 had had
1. All traceable Syme amputees attending the Edinburgh limb centre have been seen and reviewed. They number sixty-seven. Forty had amputations twenty-five or more years before. 2. There are seventy-one surviving stumps. One has
Many authors have reported a shorter treatment time when using trifocal bone transport (TFT) rather than bifocal bone transport (BFT) in the management of long segmental tibial bone defects. However, the difference in the incidence of additional procedures, the true complications, and the final results have not been investigated. A total of 86 consecutive patients with a long tibial bone defect (≥ 8 cm), who were treated between January 2008 and January 2015, were retrospectively reviewed. A total of 45 were treated by BFT and 41 by TFT. The median age of the 45 patients in the BFT group was 43 years (interquartile range (IQR) 23 to 54).Aims
Patients and Methods