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Volume 34-B, Issue 3 August 1952

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J. E. Caughey
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Fourteen patients with dystrophia myotonica and a post-mortem report of another case are reported. All had radiological or other evidence of abnormalities of the skull. The most constant were a thickened calvarium, hyperostosis interna, small to very small pituitary fossa and extensive sinuses. It is believed that the high incidence of these changes cannot be coincidental and it is held that they should be accepted as some of the variable features of dystrophia myotonica.


John Aitken
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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.


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George Bonney Ian Macnab
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1. A survey has been made of 518 operations for hallux valgus and hallux rigidus.

2. The methods of critical examination used in this survey are described.

3. The results obtained have led to the formulation of certain views on etiology and modes of treatment.

4. In hallux valgus in the adolescent, operations aimed at correcting the primary deformity are justifiable when correctly performed, though the exact form such operations should take still requires further study.

5. In hallux valgus in the adult, arthroplasty offers a reasonably good solution in the well chosen case, though no one should consider that the results are so good as to make unnecessary any further research in this field. Metatarsal osteotomy has in the adult only a limited sphere of application.

6. In hallux rigidus arthroplasty alone has no place in the treatment of the adult cases showing metatarsus primus elevatus, nor in the adolescent case. The possibilities of other methods of operative treatment, notably osteotomy, are discussed.


H. J. Seddon
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Traumatic neuritis of the deep branch of the ulnar nerve may be caused by compression of the nerve by a ganglion originating in a carpal joint, and removal of the protrusion is followed by a prompt recovery. This lesion was found in four out of five explorations.


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Donal M. Brooks
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1. Thirteen cases are reported of nerve compression by a ganglion. At operation a connection between the ganglion and the neighbouring joint was established in many instances.

2. It is suggested that so-called ganglia of the nerve sheath and simple ganglia are anatomical varieties of the same entity.

3. The treatment of choice is excision of the ganglion. If this procedure is technically difficult, puncture is advisable.

4. Recovery of sensibility after operation was good. Motor recovery was poor when damage to motor fibres occurred during excision of the ganglion or when paralysis had been present for more than eighteen months.


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S. Aubrey Jenkins
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1. Three solitary tumours of the peripheral nerve trunks are reported. None of the patients showed evidence of von Recklinghausen's disease.

2. The origin of these tumours is discussed; the evidence suggests that they develop from the Schwann cells of the nerve sheaths, and they should therefore be called neurilemmomas.

3. A solitary tumour of a peripheral nerve trunk is usually a neurilemmoma and not a neurofibroma.

4. These tumours are often mistaken for neurofibromas, from which they are wholly distinct. They are uncommon, but probably occur more often than is generally appreciated.

5. A neurilemmoma is a benign tumour which can be distinguished from a neurofibroma on clinical and operative grounds. It must be enucleated with preservation of its parent nerve. There is negligible risk of recurrence and no risk of malignant change after operation.

6. Neurilemmomas are liable to cystic degeneration, especially in situations where they are subjected to pressure or injury. This cystic change may later destroy the usual cellular structure of the tumour and convert it into a simple cyst.


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M. E. Winston
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1. Seven cases of haemophiliac arthropathy of the hip joint are reported.

2. Attention is drawn to the different appearances in the hip when it is affected before and after puberty. Before puberty there are features similar to pseudocoxalgia. After puberty there may be cyst formation, coxa valga, or features similar to osteoarthritis.

3. It is suggested that intra-osseous haemorrhage is important in the production of these changes and that intra-epiphysial haemorrhage is responsible for the appearances seen before puberty.


E. W. Somerville
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This paper is a theoretical and experimental study of the processes involved in the development of curvature of the spine which we have come to call scoliosis. Reasons are advanced why the term scoliosis in its modern meaning may be misleading and an alternative title of Rotational Lordosis is suggested. It is admitted that it is more cumbersome, but I maintain that it is more accurately descriptive of the deformity under discussion and differentiates it from other curvatures which are produced differently but at present all of which come under the heading of scoliosis. I am conscious that many gaps still remain unfilled, especially the important but unexplained problem of the nature of the growth disturbance. If we could solve this we would be near to a solution of one of the most bizarre, mysterious and crippling deformities with which we are faced.


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G. C. Lloyd-Roberts
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W. H. Kirkaldy-Willis A. S. Mbuthia
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J. G. Murray
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1. Two cases of Paget's disease of the calcaneum are reported; in both, the primary complaint was of pain in the heel.

2. In the first case there were no demonstrable lesions elsewhere, but in the second the typical radiographic appearances of Paget's disease were shown in other bones.

3. The literature on the subject is briefly reviewed.


Sven Ethelberg John Riishede
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R. McL. Todd S. E. Keidan
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1. Two children suffering from Gaucher's disease, who developed changes in the femoral head typical of Perthes' disease, are reported. Similar changes have been recorded in the literature in seventeen children under the age of fifteen years.

2. The possible factors giving rise to the bone changes are discussed and it is considered that they result from aseptic necrosis. Splenectomy does not appear to hasten the development of bone changes in this disease.

3. In one of the patients, the blood Wassermann reaction was positive, but syphilis was not thought to play any part in the production of the bone changes.


GAUCHER'S DISEASE IN BONE Pages 454 - 459
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F. W. T. Davies
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O. J. Vaughan-Jackson
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H. L.-C. Wood
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GAUCHER'S DISEASE Pages 464 - 465
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N. E. James
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A. J. E. Cave R. Warwick Brown
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1. The descriptive anatomy of the tendinous component of the subclavius muscle is amplified.

2. The subclavius tendon comprises a shorter, medial pars libera, continuous with a longer, narrower, more lateral pars paramuscularis. This last may be prolonged further laterally by two or three tendinous fasciculi.

3. Both parts of the subclavius tendon are constant. By tenodesis they provide, on the average, one and a half to two inches of material eminently suitable for employment in the functional replacement of a damaged costo-clavicular ligament.


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R. J. Last
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G. A. Labdoff
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The experiments showed that the administration of sodium citrate retards fracture healing. This is probably due to a change in the solubility of the calcium or to a relative calcium deficiency on account of the excretion in the urine, or to a combination of both factors. Other reasons cannot, however, be excluded, such as a biochemical effect on the ground substance or an enzyme deficiency.


ARTHUR TRACY CABOT Pages 477 - 477
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W. R. Bett
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Sir William Arbuthnot Lane Pages 478 - 482
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ARTHUR ROCYN JONES
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St J. D. Buxton
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Harry Platt
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H. Jackson Burrows
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Norman Capener
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Norman Capener
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George Perkins
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George Perkins
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St J. D. Buxton
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J . Paterson Ross
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David Le Vay
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J. G. Bonnin
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D. Ll. Griffiths
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George Perkins
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Philip Wiles
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Bryan McFarland
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David Le Vay
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Philip Wiles
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Philip Wiles
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J. Trueta
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