1. Four cases of facial paralysis from the incorrect use of Von Rosen or Barlow type splints are described. 2. Attention is drawn to the subcutaneous and therefore vulnerable position of the facial nerve in the newborn

1. Butler's operation for the correction of the dorsally adducted fifth toe is described. 2. It is a simple and safe operation not needing splints, and giving good reliable results. 3. The results of seventy operations performed over ten years are studied

I have tried to stimulate interest in movement as a method of treatment. It is too much to expect that I shall have won over to my way of thinking doctors who are addicts of rest. I shall be content if they will occasionally ask: "Is my splint really necessary?"

1. Dislocation and subluxation of the hip has been produced in young rats by application of splints reaching from the hip to the foot, bringing the hip into extension. 2. Progressive acetabular dysplasia and anatomical abnormalities of the head and neck of the femur occurred. 3. Results of the experiments suggest that post-natal extension of the hip is of importance in the pathogenesis of congenital dislocation of the hip in man

We studied, ten patients (11 elbows) who had undergone 14 allograft-prosthesis composite reconstructions following failure of a previous total elbow replacement with massive structural bone loss. There were nine women and one man with a mean age of 64 years (40 to 84), who were reviewed at a mean of 75 months (24 to 213). One patient developed a deep infection after 26 months and had the allograft-prosthesis composite removed, and two patients had mild pain. The median flexion-extension arc was 100° (95% confidence interval (CI) 76° to 124°). With the exception of the patient who had the infected failure, all the patients could use their elbows comfortably without splints or braces for activities of daily living. The mean Mayo Elbow Performance Index improved from 9.5 (95% CI 4.4 to 14.7) pre-operatively to 74 (95% CI 62.4 to 84.9) at final review. Radiologically, the rate of partial resorption was similar in the humeral and ulnar allografts (three of six and four of eight, respectively; p > 0.999). The patterns of resorption, however, were different. Union at the host-bone-allograft junction was also different between the humeral and ulnar allografts (one of six and seven of eight showing union, respectively; p = 0.03). At medium-term follow-up, allograft-prosthesis composite reconstruction appears to be a useful salvage technique for failed elbow replacements with massive bone loss. The effects of allograft resorption and host-bone-allograft junctional union on the longevity of allograft-prosthesis composite reconstruction, however, remain unknown, and it is our view that these patients should remain under long-term regular review

A 16-year-old boy was involved in an agricultural accident in which he sustained a large wound to the right arm and forearm. Radiological examination showed loss of the distal half of the humerus. A posterior splint was applied and after two months there was regeneration of the distal humerus including the articular portion. He was able to use his arm at five months. Twenty years later, he had a painless elbow and a 70° range of movement

From 1962 to 1986, 117,256 neonates were screened for congenital dislocation of the hip (CDH). When the primary physical examination was performed by the junior paediatric staff there was a persistent late diagnosis rate of 0.5 per 1000 live births. When the primary examination was undertaken by experienced orthopaedic personnel (1982 to 1984) the late diagnosis rate fell and fewer infants were splinted

We suggest that, after an initial course of treatment in the accepted manner by gentle manipulations without anaesthetic, followed by splinting for a period of three or four months, the talo-calcaneal index should be measured on radiographs taken in the standard positions described. Should the correction be inadequate–that is, should the talo-calcaneal index be under 40 degrees even though clinically the foot appears corrected–further treatment should immediately be undertaken

1. This clinical investigation compares the results with varying periods of immobilisation after the primary repair of extensor tendons over the metacarpo-phalangeal joints of the fingers. 2. One hundred and thirty-seven Bantu mine workers with such injuries were each splinted for either one day, ten days or three weeks, and the results were compared. 3. The results indicate that the optimum period of splintage is ten days

1. A specially designed splint is described with which it is possible to maintain the reduction of a paralytic dislocation in a child with spina bifida cystica. The results of its use in a series of thirteen cases are recorded. 2. It is suggested that all such children presenting in the first year of life, in whom the power of the flexor and adductor muscle groups is preserved, should be treated initially in this way until the prognosis for the individual can be accurately assessed. 3. The theoretical implications of the findings are discussed

1. In a survey of 107 cases of Erb's paralysis, twenty-seven instances of incipient or actual posterior dislocation of the upper end of the radius were discovered. 2. The type of case in which the dislocation occurs is defined and the early clinical and radiographic signs of the displacement are described and illustrated. 3. The probable causes—muscle imbalance and rigid splinting over a long period—are adumbrated and the prevention and remedies are suggested. 4. The occurrence of anterior dislocation—six cases—and its significance are discussed

We reviewed 31 patients at a mean of five years after mallet deformity of the finger had been treated with a thermoplastic splint. Intra-articular fractures were present in 35% of patients. Osteoarthritic changes had developed in 48%, most in association with fracture, and 29% had a swan-neck deformity. There was a loss of extension greater than 10° in 35%; the average deficit at the interphalangeal joint was 8.3° and the average flexion arc was 48.5°. Despite these findings, patient satisfaction was generally high, with little evidence of functional impairment

One hundred and twenty-nine unselected club feet were classified at birth into three grades of severity; 123 were followed up. The results of primary treatment were analysed and it is shown that the bad feet did worst. Serial splinting in plasters achieved lasting correction in nine in ten mild club feet, in half of the moderately deformed, but in only one in ten of the severely affected. Surgical correction succeeded in two out of three of the resistant feet, but had to be repeated in the others

Supracondylar osteotomy for traumatic cubitus varus is usually considered to be difficult, and to have a significant incidence of complications. Most difficulty is in maintaining correction after operation. We report 20 osteotomies performed by a modification of French's technique and managed postoperatively with the elbow extended. When a plaster splint was used only three of seven cases had good or satisfactory results, two requiring revision. Postoperative management by straight arm traction maintained correction and achieved a good or satisfactory result in all 13 cases. This new technique is recommended

A comparative study of methods for treating fractures of the distal half of the femur was carried out prospectively in the five-year period January 1973 to December 1977. The three methods compared were conservative treatment on a Thomas' splint, application of a knee-hinged cast-brace at five to seven weeks, and intramedullary nailing. The time in bed, in hospital and to union were compared as was the rate of functional recovery of the knee. It is concluded that the cast-brace provides a safe reliable method of treatment, combining the advantages of non-operative management with the early mobilisation possible with intramedullary fixation but without the disadvantages of surgical treatment

In 13 patients (18 fingers) we used two types of external fixator as progressive static splints for the preoperative correction of the deformities of severe Dupuytren’s disease before conventional fasciectomy. The duration of treatment was from one to four weeks. At a mean follow-up of 18 months the mean total fixed flexion deficit had been reduced from 138° to 39° and the mean proximal interphalangeal joint contracture from 80° to 29°. The mean total active range of movement had increased from 123° to 175°. These preliminary results are promising, but continued follow-up is needed since recurrence is common

We have reviewed 15 patients with infected total knee replacements after removal of the prosthesis, rigorous debridement, antibiotic irrigation, and prolonged systemic antibiotics. Infection was permanently eradicated in all patients; they were left with a functioning limb, on which they could walk with either a caliper (8 patients), a simple splint (3), crutches, or sticks. Three were disappointed because of residual pain. We believe that, if exchange arthroplasty is inappropriate, this procedure is preferable to arthrodesis or amputation for persistent and disabling infection, particularly where constrained artificial joints have been used

1. A method of medullary nailing of fractures of the shaft of the tibia with a straight clover-leaf nail of large calibre is described. The nail is introduced, without exposure of the fracture, through the deep infrapatellar bursa. No external splint is used and the patient is usually allowed to walk as soon as the wound is healed. The technique is essentially that of Küntscher. 2. The results obtained in the first fifty patients so treated are described. The average period of absence from work for those twenty-five whose treatment was satisfactory was eleven weeks. There were no cases of sepsis or non-union; the only difficulties encountered were mechanical ones