1. Congenital dislocation of the hip in identical twins is reported. 2. The heredity of congenital dislocation of hip is discussed. Studies in twins show that congenital dislocation of hip is probably a hereditary dysplasia of the acetabulum and upper end of the femur, and that external factors play a less important role

1. Un reduced anterior dislocation of the hip is very uncommon. Four cases are reported. 2. The aim of treatment is to correct the deformity, to improve the gait and to produce pelvic stability. 3. Osteotomy of the femur at the trochanteric level is the simplest corrective operation and will greatly improve the function of the limb

1. An attempt has been made to correlate the radiographic appearances and the morbid anatomy of the cystic changes that occur in the head of the femur in advanced osteoarthritis. 2. The suggestion is made that these lesions are foci of traumatic bone necrosis. Repair may be complicated by the subsequent entrance of synovial fluid through defects in the surface

We report our experience of lengthening by over 30% a total of 117 lower limbs in achondroplastic patients. We have compared four methods: transverse osteotomy, oblique osteotomy, callotasis of the shaft and chondrodiatasis of the epiphysis. Chrondrodiatasis of the femur and callotasis of the tibia are the techniques which gave fewest complications

Objectives

The treatment of osteoporotic fractures is a major challenge, and the enhancement of healing is critical as a major goal in modern fracture management. Most osteoporotic fractures occur at the metaphyseal bone region but few models exist and the healing is still poorly understood. A systematic review was conducted to identify and analyse the appropriateness of current osteoporotic metaphyseal fracture animal models.

We studied the effect of the surface finish of the stem on the transfer of load in the proximal femur in a sheep model of cemented hip arthroplasty. Strain-gauge analysis and corresponding finite-element (FE) analysis were performed to assess the effect of friction and creep at the cement-stem interface. No difference was seen between the matt and polished stems. FE analysis showed that the effects of cement creep and friction at the stem-cement interface on femoral strain were small compared with the effect of inserting a cemented stem

1. Previous investigations into the blood supply of the femoral shaft are reviewed. 2. Details of the blood supply of the shaft of the femur in seventeen children under one year of age, and in ten adults, are given. 3. These findings are discussed with special reference to the fate of the femoral shaft after fracture or operation

We reviewed ten patients with metastatic carcinoma and impending pathological fractures of the subtrochanteric region of the femur who had prophylactic insertion of the Russell-Taylor reconstruction nail. There were no operative complications or long-term mechanical failures. This reconstruction nail has some technical and biomechanical advantages over other implants and is ideal for the management of such cases

Aims

The outcome of total knee arthroplasty (TKA) is not always satisfactory. The purpose of this study was to identify satisfaction and biomechanical features characterising the gait of patients who had undergone TKA with either an anatomical single radius design or a medial pivot design. We hypothesised that the latter would provide superior function.

A case is described of malignant osteoclastoma of the lower end of the femur in which death occurred from pulmonary metastases. The history was short and there was no interference with the primary growth, treatment being confined to disarticulation at the hip. Reasons are given for considering this neoplasm a malignant osteoclastoma rather than an osteogenic sarcoma, and the question of nomenclature is discussed

Our purpose was to determine the mechanism which allows the maximum knee flexion in vivo after a posterior-cruciate-ligament (PCL)-retaining total knee arthroplasty. Using three-dimensional computer-aided design videofluoroscopy of deep squatting in 29 patients, we determined that in 72% of knees, direct impingement of the tibial insert posteriorly against the back of the femur was the factor responsible for blocking further flexion. In view of this finding we defined a new parameter termed the ‘posterior condylar offset’. In 150 consecutive arthroplasties of the knee, the magnitude of posterior condylar offset was found to correlate with the final range of flexion

Objectives

This systematic review aimed to assess the in vivo and clinical effect of strontium (Sr)-enriched biomaterials in bone formation and/or remodelling.

We report our experience of surgical treatment for instability of flail knees after poliomyelitis in 228 patients. We made carefully selective use of soft-tissue release, extension osteotomy of the femur, and a patellar bone block for hyperextension. After six to nine years follow-up, 87% of the patients had retained significant improvement in stability and walking ability

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

1. A patient of sixty-eight suffering from enchondromatosis (Ollier's disease) is described. 2. A malignant tumour developed in the region of the lesser trochanter of the femur. Histological investigation established that it was an osteosarcoma. 3. Other features of interest are the radiographic appearance of Ollier's disease at an advanced age, and the presence of subcutaneous subcostal and retroperitoneal haemangiomata

Callus formation and the rate of union of nailed fractures of the femur has been determined in 22 patients with associated head injuries and compared with that in a group of patients with similarly treated fractures but without head injuries. The comparison confirms the widely held view that, in patients with head injuries, fractures frequently heal with excessive callus and at a faster rate than normal

1. Three cases are reported of avascular necrosis of the head of the femur after undisplaced fractures of the neck of the femur in childhood. 2. It is suggested that the diaphysial vessels play a more important part in the supply of the epiphysis than has previously been recognised. 3. The prognosis for any fracture of the neck of the femur in a child given at the time of the injury should be guarded

Our study evaluated the accuracy of an image-guided total knee replacement system based on CT with regard to preparation of the femoral and tibial bone using nine limbs from five cadavers. The accuracy was assessed by direct measurement using an extramedullary alignment rod without radiographs. The mean angular errors of the femur and tibia, which represent angular gaps from the real mechanical axis in the coronal plane, were 0.3° and 1.1°, respectively. The CT-based system, provided almost perfect alignment of the femoral component with less than 1° of error and excellent alignment with less than 3° of error for the tibial component. Our results suggest that standardisation of knee replacement by the use of this system will lead to improved long-term survival of total knee arthroplasty

Thirty-two neglected congenital dislocations of the hip in twenty-two children over the age of six years were treated by traction, open reduction and Chiari osteotomy. In five hips, where prolonged traction failed to bring the femoral heads into the vicinity of the acetabulum, a shortening subtrochanteric osteotomy of the femur was performed. The overall results were good and this regime of treatment is recommended

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