The growth of the stump has been studied in eighteen children with below-knee amputations. Measurements were available shortly after operation and later at skeletal maturity. It was found that all patients achieved less than expected growth and that the reduction was greater in those patients who had had amputation for congenital deformity

The results of fifty-one Manchester knee arthroplasties in forty-one patients are reviewed and discussed. Excellent and good results were obtained in 85.4 per cent of arthroplasties. Varus and valgus deformity can be corrected and stability preserved or restored. Complications occurred in only twelve patients but resolved in all except one

It is suggested that there is a group of cases of congenital angulation of tubular bones in which the lesion is a defect of ossification of the primary cartilaginous anlage and in which neurofibromatosis is not implicated. It appears that in this group the prognosis with regard to the resolution of deformity and the prevention of pseudarthrosis with conservative treatment or relatively simple surgical procedures is better than that in the neurofibromatous type

1. The indications for correction of severe rigid kyphosis by lumbar osteotomy are described. 2. The fatal complications in a series of a hundred cases are listed. With more experience of this operation they should be considerably reduced. 3. Among the non-fatal complications the low incidence of recurrence of the deformity severe enough to require further operation is noteworthy

1. The literature dealing with congenital bowing of the tibia has been reviewed, and three types of deformity have been distinguished. 2. Five examples of the third type, in which the bowing is posterior and medial, are presented. 3. The characteristic features of the clinical entity are described, and the satisfactory response to conservative treatment is illustrated

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

Varus osteotomy of the distal femur is recommended for osteoarthritis of the knee with significant valgus deformity, but the operation is difficult to plan and perform. A simple technique involving a jig referenced to the line of the tibia is described. This allows accurate overcorrection by a few degrees, with impaction and secure fixation at the osteotomy. It has been successful, with no complications, in 12 consecutive knees

Instability may present at a different level after successful stabilisation of an unstable segment in apparently isolated injuries of the cervical spine. It can give rise to progressive deformity or symptoms which require further treatment. We performed one or more operations for unstable cervical spinal injuries on 121 patients over a period of 90 months. Of these, five were identified as having instability due to an initially unrecognised fracture-subluxation at a different level. We present the details of these five patients and discuss the problems associated with their diagnosis and treatment

1. From India a family is reported in which fifteen of fifty-seven were affected by the nail-patella syndrome. 2. Additional coincidental features not described previously were fiexion deformities of both hips and hyperextension of the interphalangeal joints of the fingers. 3. Patients affected by the condition do not always show the same blood group

A carefully planned operation may be expected to check increasing deformity without doing harm, and to make subsequent bony stabilisation easier. In favourable cases it may be possible to restore muscle balance and stability, making further surgery unnecessary. A longer follow-up is necessary to determine to what extent this ideal can be achieved

We have treated seven children with relapsed infantile Blount’s disease by elevation of the hemiplateau using the Ilizarov frame. Three boys and four girls with a mean age of 10.5 years were reviewed at a mean of 29 months after surgery. All had improved considerably and were pleased with the results. The improvements in radiological measurements were statistically significant (p < 0.001). Three-dimensional CT reconstruction was useful for planning surgery. There were no major complications. The advantages of this technique are that in addition to elevation of the hemiplateau, rotational deformities and limb-length discrepancies may be addressed

Objectives

The objective of this study was to quantify the relative movement between the articular surfaces in the tibiotalar and subtalar joints during normal walking in asymptomatic individuals.

Idiopathic osteolysis is characterised by a spontaneous onset without previous causative factors, followed by rapid destruction and resorption of the involved bones. This process can result in severe deformities with joint subluxation and instability. In certain forms an associated malignant nephropathy may develop. A case report is presented which illustrates the destructive nature of the process

1. Seven cases of old unreduced anterior dislocation of the hip are reported. Six were complicated by myositis ossificans. 2. Four cases resulted from the fall of a heavy object on the lower back of a stooping person. 3. Trochanteric osteotomy in five cases not only corrected the deformity but gave stable, serviceable hips

1. A case of posterior interosseous nerve palsy from compression in the supinator muscle by what appeared to be a simple ganglion is described. 2. Surgical decompression led to an effective cure. 3. The course of the nerve through this muscle invites compression. 4. Rotation of the forearm, especially with super-added deformity of the limb, may increase the compresssion

A boy aged eleven with a solitary chondroma of the right tibia, and angiomata of the skeletal muscle, subcutaneous tissues, and periarticular tissues of the same limb, is considered to be a case of Maffucci's syndrome (dyschondroplasia with angiomata), although there was not the severe deformity encountered in the previously reported cases. There was a secondary atrophy and adiposity of skeletal muscle, and this was attributed to anoxic effects produced by the angiomata

Replacement of the shoulder in juvenile idiopathic arthritis is not often performed and there have been no published series to date. We present nine glenohumeral hemiarthroplasties in eight patients with systemic or polyarticular juvenile idiopathic arthritis. The mean follow-up was six years (59 to 89 months). The mean age at the time of surgery was 32 years. Surgery took place at a mean of 27 years after diagnosis. The results indicated excellent relief from pain. There was restoration of useful function which deteriorated with time, in part because of progression of the systemic disease in this severely affected group. No patient has required revision to date and there has been no radiological evidence of loosening or osteolysis around the implants. We discuss the pathoanatomical challenges unique to this group. There was very little space for a prosthetic joint and, in some cases, bony deformity and the small size necessitated the use of custom-made implants

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 foot is of further interest

1. An oblique displacement osteotomy of the distal third of the first metatarsal is described for the correction of adolescent hallux valgus. 2. No fixation of the fragments is necessary, stability depending upon displacement in the over-corrected position for two weeks. 3. A follow-up of twenty-five operations has shown only one failure, from recurrence of the deformity. There have been no complications

1. A method of correcting poliomyelitic lateral rotation deformity of the thigh by transplant of one or more of the hamstring muscles to the femur is described. 2. The results in seven cases are recorded. 3. Though it is emphasised that this is no more than a preliminary communication and the number of patients so treated is small, the satisfactory results suggest that the procedure is mechanically and physiologically sound