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The Journal of Bone & Joint Surgery British Volume
Vol. 84-B, Issue 7 | Pages 1084 - 1085
1 Sep 2002
CHESSER TJS LANGDON IJ OGILVIE C SARANGI PP CLARKE AM


The Journal of Bone & Joint Surgery British Volume
Vol. 83-B, Issue 8 | Pages 1209 - 1210
1 Nov 2001
CHESSER TJS SARANGI PP LANGDON IJ OGILVIE C CLARKE AM


The Journal of Bone & Joint Surgery British Volume
Vol. 83-B, Issue 3 | Pages 423 - 426
1 Apr 2001
Chesser TJS Langdon IJ Ogilvie C Sarangi PP Clarke AM

Splitting fractures of the humeral head are rare; part of the humeral head dislocates and the unfractured part remains attached to the shaft. We report eight cases in young patients. In five the diagnosis was made at presentation: three had minimal internal fixation using a superior subacromial approach, one had a closed reduction and one a primary prosthetic replacement. All five patients regained excellent function with no avascular necrosis at two years. In three the injury was initially unrecognised; two developed a painless bony ankylosis and one is awaiting hemiarthroplasty.

It is important to obtain the three trauma radiographic views to diagnose these unusual fractures reliably. CT delineates the configuration of the fracture. In young patients open reduction and internal fixation seems preferable to replacement of the humeral head, since we have shown that the head is potentially viable.


The Journal of Bone & Joint Surgery British Volume
Vol. 68-B, Issue 5 | Pages 767 - 769
1 Nov 1986
Ogilvie C Sharrard W

In paralytic lesions in which the triceps surae is the only active muscle in the leg, elongation or division of the tendo calcaneus alone may not be enough to prevent recurrence of equinus deformity. In 10 patients (13 limbs) with this pattern of muscle activity, equinus deformity was treated by hemitransplantation of the tendo calcaneus. At follow-up, which was beyond the end of growth in seven limbs, there was no recurrence of deformity in nine. In three of the four failures, a technical fault may have caused loss of activity in the transplanted part of the tendon. The two-stage operation described is recommended in the management of this pattern of paralytic deformity.