1. Thirteen cases of traumatic separation of the upper femoral epiphysis have been studied. Four were previously reported and nine new cases are analysed. 2. This is a rare injury occurring in young children and is due to severe violence. 3. Separation occurred at the epiphysial plate, and severe
1. The complications following standard tendon transfer to provide active correction of drop foot in Chinese patients with leprosy are reviewed. 2. An alternative method of foot drop correction is described in which reactivation of the remaining distal stump of the tibialis
We report 17 patients who had grafting of the common peroneal nerve after traction injuries. Sixteen were reviewed at a median follow-up of 36 months. The nerve gap ranged from 7 to 20 cm. A functionally satisfactory result was achieved in six patients (37.5%), a fair result in six and a poor result in four. Seven patients had, in addition, a
To evaluate the incidence of primary venous thromboembolism (VTE),
epidural haematoma, surgical site infection (SSI), and 90-day mortality
after elective spinal surgery, and the effect of two protocols for
prophylaxis. A total of 2181 adults underwent 2366 elective spinal procedures
between January 2007 and January 2012. All patients wore anti-embolic
stockings, mobilised early and were kept adequately hydrated. In
addition, 29% (689) of these were given low molecular weight heparin
(LMWH) while in hospital. SSI surveillance was undertaken using the
Centers for Disease Control and Prevention criteria.Aims
Patients and Methods
Ultrasound (US) was used to determine the congruity of the shoulder in 22 children with a deformity of the shoulder secondary to chronic obstetric brachial plexus palsy. There were 11 boys and 11 girls with a mean age of 4.75 years (0.83 to 13.92). The shoulder was scanned in the axial plane using a
As one of the heat-stable enterotoxins, Rat MSCs were used to test the effects of SEC2 on their proliferation and osteogenic differentiation potentials. A rat femoral fracture model was used to examine the effect of local administration of SEC2 on fracture healing using radiographic analyses, micro-CT analyses, biomechanical testing, and histological analyses.Objectives
Materials and Methods
Our previous reports on the pathological anatomy and operative treatment of intra-articular fractures of the calcaneum failed to take account of the fracture pattern anterior to the
We reviewed radiographs and CT scans of 38 total hip arthroplasties which had dislocated (36
The results of operation performed within the first six months of life upon seventy-seven resistant club feet are presented. The indications for and the rationale of early operation are discussed. Particular attention has been paid to the relationship between the age at operation and the outcome more than four years later; the results were greatly superior when operation was undertaken early. Two surgical techniques are compared, the postero-medial release proving better than a simple
The pattern of fracture-dislocation of the upper part of the sacrum is demonstrated in three patients. The fracture line followed the segmental form of the sacrum and was usually caused by a
1. Thirty-seven cases of fracture of the dens have been studied. 2. The incidence of non-union was high: 64 per cent after apparently adequate closed treatment. 3. Possible causes of the high incidence of non-union have been studied : attention is drawn to the effect of displacement and to that of
1. The spinal branches of the vertebral artery were injected with a suspension of barium sulphate and the blood supply of the vertebral bodies of the lower four or five cervical vertebrae investigated radiologically. 2. Beneath the
1. As a result of degenerative changes in the intervertebral disc, nuclear tissue often herniates through its confining structures. These lesions are common, even in children, and often lead to difficulty in diagnosis. 2. The radiological manifestations of nuclear herniations into the spongiosa of the vertebral body, through the anterior part of the annulus fibrosus, beneath the epiphysial ring, and through the
The physiological role of mechanoreceptors in the anterior cruciate ligament (ACL) was studied in unanaesthetised decerebrate-spinalised cats and dogs. Tonic activity in the quadriceps and the hamstring increased in response to physiological loading of the ACL. Evoked potentials in the
Our objectives were to establish the envelope of passive movement and to demonstrate the kinematic behaviour of the knee during standard clinical tests before and after reconstruction of the anterior cruciate ligament (ACL). An electromagnetic device was used to measure movement of the joint during surgery. Reconstruction of the ACL significantly reduced the overall envelope of tibial rotation (10° to 90° flexion), moved this envelope into external rotation from 0° to 20° flexion, and reduced the anterior position of the tibial plateau (5° to 30° flexion) (p <
0.05 for all). During the pivot-shift test in early flexion there was progressive anterior tibial subluxation with internal rotation. These subluxations reversed suddenly around a mean position of 36 ± 9° of flexion of the knee and consisted of an external tibial rotation of 13 ± 8° combined with a
Fractures of the navicular can occur in isolation but, owing
to the intimate anatomical and biomechanical relationships, are
often associated with other injuries to the neighbouring bones and
joints in the foot. As a result, they can lead to long-term morbidity
and poor function. Our aim in this study was to identify patterns
of injury in a new classification system of traumatic fractures
of the navicular, with consideration being given to the commonly associated
injuries to the midfoot. We undertook a retrospective review of 285 consecutive patients
presenting over an eight- year period with a fracture of the navicular.
Five common patterns of injury were identified and classified according
to the radiological features. Type 1 fractures are dorsal avulsion
injuries related to the capsule of the talonavicular joint. Type
2 fractures are isolated avulsion injuries to the tuberosity of
the navicular. Type 3 fractures are a variant of tarsometatarsal
fracture/dislocations creating instability of the medial ray. Type
4 fractures involve the body of the navicular with no associated
injury to the lateral column and type 5 fractures occur in conjunction
with disruption of the midtarsal joint with crushing of the medial
or lateral, or both, columns of the foot.Aims
Patients and Methods
We reviewed 19 children who had undergone a new modification of the L'Episcopo procedure for obstetric brachial plexus palsy. Through an axillary approach the latissimus dorsi tendon was re-routed anteriorly to the humerus and then anastomosed to the teres major tendon routed
The radiological and MRI appearances of 24 knees with patellar tendonitis resistant to conservative therapy were analysed to identify the characteristic MRI appearance and to determine if the patellar morphology was abnormal. A significant thickening of the tendon was found in all cases; this was a more reliable diagnostic feature than a high signal within the superior
We studied the aetiology of vertebral slip in a long-term follow-up of 22 adult patients with isthmic spondylolysis or spondylolisthesis of L5. Of the 18 with spondylolysis without slip, 13 showed no slip after ten years, but five developed displacement of over 5%. All four patients with spondylolisthesis showed progression of the slip. We found that the vertical thickness of the transverse process of L5 was significantly greater (p <
0.01) in the 13 patients with no slip than in the other two groups. The relationship of vertebral slip to the shape of the transverse processes of L5 may be explained by differences in the bulk or physiological strength of the