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Volume 33-B, Issue 1 February 1951

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Joseph S. Barr
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B. H. Burns
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F. R. Wilkinson
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John E. A. O'Connell
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1. Excision of a lumbar intervertebral disc protrusion is required in only a small proportion of patients with this lesion.

2. A careful clinical and radiological examination of cases of lumbago and pain in the lower limb provides good evidence not only of the presence of a lumbar intervertebral disc protrusion but also of its anatomical level, size and relationships. Such examination is essential for the selection of the patients requiring surgical treatment.

3. In most of these selected cases, a carefully performed operation designed to relieve the affected nerve fibres from forces which stretch and compress them will give satisfying relief of symptoms. In the series reported, 92 per cent of patients were either completely free from symptoms or very greatly improved after operation.

4. The spinal and tension signs present before operation largely disappeared after it. Persistence of a pre-operative neurological deficit after operation is, however, relatively frequent, though seldom disabling.

5. The incidence of post-operative recurrence of symptoms of such severity as to indicate re-operation in the series was 2 per cent.


J. R. Armstrong
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Bryan McFarland
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1. The results of the by-pass grafting operation in eleven cases of pseudarthrosis of the tibia in childhood are presented.

2. The operation was successful in securing sound bone union in nine cases, and unsuccessful in two.

3. The causes of failure in the two unsuccessful cases are analysed.

4. The possible causes of occurrence and persistence of tibial pseudarthrosis in childhood are discussed.

5. It is suggested that the pseudarthrosis results from a fatigue fracture of a congenitally abnormal tibia, but that its persistence depends entirely on mechanical factors.

6. There is evidence to suggest that the underlying congenital abnormality may arise from dysplasia of the mesenchyme.


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A. N. Birkett
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B. F. Miller
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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.


Douglas L. Savill
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1. Pathological changes occurred in the manubrio-sternal joint in 72 per cent of a series of sixty-one cases of ankylosing spondylitis.

2. In all the twenty-one patients over the age of thirty-five years the joint was undergoing a process of fusion that was found in only seven of sixty healthy persons in the same age group.

3. In the age groups twenty-five to forty-four, thirty-five out of forty-three patients with ankylosing spondylitis showed abnormality that was noted in but three of the forty healthy controls.

4. The changes in the manubrio-sternal joint are similar to those which occur in the sacro-iliac joint.

5. The accessibility of the manubrio-sternal joint makes it a convenient source of pathological material for the further histological study of the disease.


J. H. Penrose
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1. The posterior Monteggia fracture usually conforms to a typical pattern.

2. Its incidence is greatest among middle-aged women.

3. The mechanism of the injury is probably similar to that of the dislocated elbow. Excessive rotation of the forearm plays no part in its production.

4. Internal fixation of the ulna combined with excision of the whole radial head, or of its detached segment, is suggested as the treatment of choice.

5. The functional results after operation are excellent, but some slight permanent restriction of movement is to be expected.


Ch. N. Athanassiadis
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1. The clinical findings and results in seventeen patients under two years of age, suffering from acute osteomyelitis, have been studied and compared with forty-eight similar cases treated without penicillin.

2. The results in the penicillin-treated group were not greatly superior to those in the control group and did not justify the high hopes that have been entertained for penicillin as a certain cure for osteomyelitis.


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Ross Bloom J. N. Pattinson
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1. Three cases of osteochondromatosis of the hip joint are described.

2. Attention is drawn to the diagnostic importance of erosions at the junction of head and neck of the femur, and the conical shape of the femoral neck.

3. Arthrography is of particular value in diagnosis when the loose bodies are radio-translucent.


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Gawad Hamada
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A. W. Lipmann Kessel
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Two cases of lateral meningocele and spinal deformity in von Recklinghausen's disease are reported. Of the ten known cases of lateral meningocele, seven have occurred in patients with neurofibromatosis. The relation of spinal deformity and neurofibromatosis is briefly discussed.


J. D. Mulder
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1. A clinical test of diagnostic significance in Morton's metatarsalgia is described.

2. Findings at operation in twelve cases are recorded.

3. The causation of the digital neuroma is discussed.


DE QUERVAIN'S DISEASE Pages 96 - 99
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Bryan Keon-Cohen
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1. In patients who develop de Quervain's disease variations from the standard pattern of tendons at the wrist are the rule rather than the exception.

2. Conservative treatment is of no value.

3. Adequate exposure, allowing full recognition of all anatomical structures in the region, is advisable, but branches of the radial nerve must be treated with respect.

4. The extensor pollicis brevis tendon is normally small and may pass through a separate osteofibrous canal.

5. Though incision only of the stenosing tendon sheaths may be sufficient, thorough excision is more certain and does no harm.


DIAPHYSIAL ACLASIS Pages 100 - 105
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V. H. Ellis J. G. Taylor
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Alan H. Hunt Ian P. Todd
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G. O. Tippett
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W. E. Gallie
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DISRUPTION OF THE PELVIS Pages 112 - 113
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Thomas F. Rose
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R. J. Last
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Alexander Gibson Thomas H. Williams
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John Charnley
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William Adams Pages 124 - 129
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Arthur Rocyn Jones
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GATHORNE ROBERT GIRDLESTONE Pages 130 - 133
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H. J. S. H. P.
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CORRESPONDENCE Pages 141 - 141
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R. Broomhead
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George Perkins
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Arthur Keith
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D. Ll. Griffiths
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Norman Capener
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Norman Capener
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D. Ll. Griffiths
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Norman Capener
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