bluuebunny/crossref_metadata_2025 huggingface dataset:
EXOSTOSIS BURSATA
Authors: Smithuis Th.
Published: February 2018

1. Exostosis bursata in a patient with hereditary multiple exostoses is described.

2. Fracture of the tip of the exostosis had occurred causing acute pain and haemorrhage into the bursa.

3. Although it appeared that it might be a pseudo-joint cavity the histological appearance indicated that it was a bursa caused by friction between the exostosis and the surrounding soft tissue.
OSTEOMYELITIS OF THE SPINE DUE TO SALMONELLA MUENCHEN
Authors: Mills K. L. G.
Published: February 2018

A case of salmonella osteitis of the spine is described. It is thought to be the first case reported due to the serotype Salnionella muenchen.
EXCISION OF THE PROXIMAL ROW OF THE CARPUS
Authors: Crabbe W. A.
Published: February 2018

1. Excision of the proximal row of the carpus is a useful procedure, with a limited application in patients with ununited fractures of the scaphoid, Kienböck's disease, dislocation of the lunate bone, unreduced mid-carpal dislocations and similar injuries which do not respond to conservative management.

2. It is an acceptable alternative to arthrodesis, even when the wrist is likely to be subjected to heavy use.

3. In the event of failure arthrodesis can still be carried out.

4. Advanced degenerative changes are a contra-indication but mild to moderate changes do not appear to affect the results.
THE INFLUENCE OF IMMOBILISATION ON BONE FORMATION AS EVALUATED BY OSSEOUS INCORPORATION OF TETRACYCLINES
Authors: Landry M. , Fleisch H.
Published: February 2018

1. The effect of immobilisation on bone formation has been investigated in the rat. As chlortetracycline has the property of being deposited preferentially in areas of newly deposited bone, its uptake can be used as a reflection of osseous formation.

2. One hind limb of albino rats was immobilised either by section of the second, third and fourth lumbar nerve trunks or by section of tendo calcaneus and ligamentum patellae. The incorporation of chlortetracycline was determined quantitatively in the femur and tibia of both hind limbs at intervals after immobilisation.

3. Tetracycline uptake is expressed in terms of bone weight, this being most important in order to obtain correct values.

4. A comparison between the tetracycline uptake and the weight of the bones gives information about the rate of bone destruction.

5. In animals immobilised by nerve section three phases can be distinguished: a first phase with diminished bone formation, a second with increased formation and increased destruction and a third phase with diminished bone formation. Both mechanisms, decreased formation and increased destruction, are therefore important in the production of immobilisation osteoporosis; their relative importance depending upon the duration of the immobilisation.

6. In animals immobilised by tendon section the mechanical function becomes restored in the second week as a result of healing: this explains the rapid compensation for the initial loss of weight of the bones accompanied by a marked increase in tetracycline uptake.

7. These results are discussed and compared with information in the literature. Variations in bone formation and destruction rates with time could explain the varied results reported by other authors.
TRAUMATIC FEMORAL BONE LOSS
Authors: Kirkup J. R.
Published: February 2018

1. A motor-cyclist's temporary loss of ten inches (25 centimetres) of femoral shaft and its replacement are recorded.

2. The mechanism of injury is considered.

3. The management of extensive bone loss is discussed.

4. Attention is drawn to the importance of retained periosteum and its contribution to healing in such injuries.
EXPERIMENTAL EPIPHYSIAL CARTILAGE GROWTH ANOMALIES
Authors: Storey E.
Published: February 2018

1. Stable strontium in large amount in the diet of rats initially inhibits calcification and induces rickets.

2. Changes later become atypical and a complex series of epiphysial plate defects develops: formation of localised osteoid wedges in the metaphysis; invagination of the epiphysial plate and sequestration of multiple cartilage nodules into the marrow cavity; and, in severely affected animals, localised loss of part or parts of the epiphysial plate with formation of large cartilage nodules in the metaphysis and epiphysis.

3. The appearance of cartilage nodules in the metaphysis in man has been shown to be associated with changes in the epiphysial plate, but much of the information is radiological and therefore incomplete, and detailed cellular changes are seldom available.

4. Some of the conditions mentioned, which have presented difficulty in interpretation, partly because of their rarity but also because of lack of knowledge of the fundamental processes concerned, are multiple exostoses and endochondromatoses, metaphysial dysostosis and osteochondritis.

5. Comparison of basic mechanisms revealed in this study with those supposed to occur in human cartilage dystrophies demonstrates that strontium rickets mimics some changes occurring in chronic renal rickets; that invagination of the epiphysial plate and cartilage nodule sequestration could account for the development of multiple exostoses and some endochondromatoses; and that localised endochondral defects in calcification can induce epiphysial changes resembling osteochondritis juvenilis, demonstrating that avascular necrosis is not necessarily the mechanism initiating epiphysial deformity.
CALCIUM ACCRETION AND BONE FORMATION IN DOGS
Authors: Lee W. R. , Marshall J. H. , Sissons H. A.
Published: February 2018

1. In two dogs, approximately one to two years and three to four months of age, an experimental comparison was made between the calcium accretion rate as defined by the Bauer-Carlsson-Lindquist equation, and the bone formation rate determined by double tetracycline labelling.

2. The overall calcium accretion rate was determined from the specific activity of the blood plasma, and the urinary and faecal excretion of isotope, following an intravenous tracer dose of Ca45. A time of five days after injection was used for the calculation of accretion rates, but data for shorter times of calculation are included.

3. Local accretion rates were obtained for different parts of the skeleton by determining the specific activities of bone samples at the end of the experiment.

4. The amount of isotope the uptake of which was not related to new bone formation (the diffuse component) was determined autoradiographically.

5. Local values for appositional growth rate and bone formation rate were obtained, using sections of undecalcified bone specimens, by measuring the linear separation between two tetracycline bone markers and the area of new bone enclosed by them.

6. In the older dog, the measurements for cortical bone showed that the accretion rate was two to three times as great as the bone formation rate: the observed diffuse component was sufficient to account for the greater part of this difference. Measurement of the bone formation rate for cancellous bone presented difficulties, but the approximate values obtained suggested that the accretion rate and the bone formation rate were of about the same order for this tissue.

7. In the younger dog, the bone formation rate could be determined only in cortical bone: at the sites studied, the values for the accretion rate and the bone formation rate did not differ by more than 20 per cent. It is suggested that this is due partly to the low specific activity of the diffuse component in this young animal, and partly to the relatively large amounts of new bone formed during the period of the experiment.

8. Despite the important differences between the rates of calcium accretion and bone formation that were found to exist in regions where there was only a small amount of new bone formation, there was a strong correlation between the two rates. The value of the accretion rate as a parameter of bone metabolism is clear.
REPAIR OF RUPTURES OF THE ROTATOR CUFF OF THE SHOULDER
Authors: Debeyre J. , Patte D. , Elmelik E.
Published: February 2018

1. The results of operation in sixty-three patients with rupture of the rotator cuff of the shoulder have been reviewed.

2. In seventeen patients the classical delto-pectoral route was found to give poor access and mediocre results.

3. In forty-six patients a superior approach along the supraspinatus fossa and through the divided acromion process was found to give excellent access and to permit lateral advancement of the supraspinatus muscle in order to enable wide gaps to be closed. With this improved surgical access the proportion of good results has been doubled.

4. It is suggested that when a case of rupture of the cuff, confirmed by arthrography, fails to respond to physiotherapy, operative repair should be undertaken.
AINHIJM
Authors: Cole G. J.
Published: February 2018

1. An account of fifty-four patients suffering from ainhum is presented, and the clinical and pathological findings are discussed.

2. Etiology is considered, and a plan of treatment proposed.

3. Ainhum in Ibadan is a disease of all ages and both sexes.

4. Most patients have considerable pain.

5. It is due to a non-inflammatory change in the basal layer of the epidermis.

6. Surgical treatment has gratifying results.
TRUE AINHUM: ITS DISTINCTIVE AND DIFFERENTIATING FEATURES
Authors: Browne S. G.
Published: February 2018

The distinctive clinical characteristics of ainhum conforming to classical descriptions, as seen in 100 patients in Central and West Africa, are briefly reviewed, special emphasis being laid on those features that serve to differentiate ainhum from other conditions that may in some respects resemble it.
THE ELIMINATION OF SLIP BETWEEN PROSTHESIS AND FEMUR
Authors: Charnley J. , Kettlewell J.
Published: February 2018

1. The customary method of broaching and of knocking the prosthesis down into the neck of the femur produces an indeterminate interference fit.

2. The usual interference fit may suffer progressive breakdown under even small, steady loads. This results in a permanent relative movement between prosthesis and femur as the metal insert "beds " into the bone.

3. Modification of the usual practice by providing a clearance fit between prosthesis and femur and cementing of the metal into the bone provides a system which has been shown to be free of breakdown under steady loads up to about 450 pounds.

4. By cementing the prosthesis shaft into the femur permanent relative movement between the elements has been shown to be reduced from approximately four-hundredths of an inch per 100 pounds load to two ten-thousandths of an inch per 100 pounds load–that is, a reduction of 200 to 1.
DURATION OF SPLINTING AFTER REPAIR OF EXTENSOR TENDONS IN THE HAND
Authors: Stuart David
Published: February 2018

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.
THE HAEMOPHILIC PSEUDOTUMOUR OR HAEMOPHILIC SUBPERIOSTEAL HAEMATOMA
Authors: de Valderrama J. A. Fernandez , Matthews J. M.
Published: February 2018

1. The case history of a haemophiliac in whom a large haematoma of the thigh was treated by amputation of the limb is described.

2. Examination of the available radiographs and of the histology led to the conclusion that the cyst was subperiosteal in origin.

3. Evidence is presented to support the hypothesis that haemophilic pseudotumours are always associated with subperiosteal haemorrhage, and that those haemophilic cysts which are confined to muscle have little or no effect on the adjacent bone.
THE TREATMENT OF DISPLACED FRACTURES AT THE ANKLE BY RIGID INTERNAL FIXATION AND EARLY JOINT MOVEMENT
Authors: Burwell H. Nevile , Charnley Arnold D.
Published: February 2018

1. This paper presents a series of 135 patients with displaced ankle fractures treated by rigid internal fixation followed by early joint exercises in bed until movements were restored and followed then by full weight bearing in a plaster.

2. The advantages obtained are as follows: A high standard of reduction can be achieved and maintained. The joint movements are established before organisation of the traumatic exudate. Weight bearing in a plaster reduces the degree of disability and prevents osteoporosis. Further remedial treatment after removal of the plaster is usually unnecessary.

3. All but five of the fractures (3·7 per cent) could be classified in the manner described by Lauge-Hansen.

4. This classification is the most satisfactory of those available and is recommended for general use.

5. Anatomical reduction was obtained in 102 patients (77 per cent), with good objective clinical results in 108 patients (82 per cent).

6. The quality of the clinical result depends mostly on the accuracy of the reduction, to a lesser extent on the degree of initial displacement, and least on the type of fracture.

7. It is considered that the traditional concept of diastasis requires modification; it is felt that the term lateral ankle instability, which includes low fracture of the fibula (intraosseous diastasis) is preferable.

8. Internal fixation of the syndesmosis is to be avoided except in rare instances.

9. The incidence of arthritis is shown to depend mostly upon the accuracy of reduction; the initial degree of displacement is also of importance.
TENDON INJURIES AROUND THE ANKLE
Authors: Griffiths J. C.
Published: February 2018

1. An account is given of twenty patients who had sustained accidental division of one or more foot tendons (other than tendo calcaneus).

2. Severe deformities occur when these injuries are neglected in children.
STRESS FRACTURES OF THE FEMORAL NECK
Authors: Devas M. B.
Published: February 2018

1. Stress fractures of the femoral neck in twenty-five patients are described.

2. Two distinct radiological types, compression fractures and transverse fractures, are described. A clinical distinction cannot be made in the early stages.

3. The importance of the early differential diagnosis between the two types is emphasised because the transverse stress fracture of the femoral neck will become displaced.

4. The morbidity after a displaced transverse fracture of the femoral neck can be severe.
FRACTURES OF THE SHAFT OF THE HUMERUS
Authors: Klenerman L.
Published: February 2018

1. It appears that fracture of the humeral shaft occurs more often in persons over fifty. This incidence corresponds with that found in a study carried out by the Pennsylvania Orthopaedic Society in 1959.

2. The middle third of the bone is the most vulnerable portion of the shaft, where transverse fracture and radial nerve palsy most commonly occur.

3. Most fractures of the shaft of the humerus are best treated by simple splintage. The degree of radiological deformity that can be accepted is far greater than in other long bones. In this group anterior bowing of 20 degrees or varus of 30 degrees was present before it became clinically obvious and even then the function of the limb was good.

4. Internal fixation is only occasionally indicated but operation on the middle third of the bone increased the chances of delayed union.

5. In the treatment of delayed union intramedullary fixation and the application of slivers of iliac bone is effective in stimulating the fracture to join.
GLOMUS TUMOUR OF THE KNEE
Authors: Caughey D. E. , Highton T. C.
Published: February 2018

1. A case of glomus tumour of the subcutaneous tissues of the knee which presented with extreme pain is described. Successful removal of the tumour led to complete relief of pain and return to normal function.

2. The histological features are given.

3. The literature is briefly reviewed.
PATTERNS OF DISINTEGRATION OF THE TARSUS IN THE ANAESTHETIC FOOT
Authors: Harris John R. , Brand Paul W.
Published: February 2018

1. There seem to be two distinct methods of destruction of the foot, once pain sensibility has been lost: the first is a slow erosion and shortening associated with perforating ulcers under the distal weight-bearing end of the foot. The second is a proximal disintegration of the tarsus in which mechanical forces often determine onset and progress of the condition.

2. Once the tarsus begins to disintegrate it is difficult to halt the rapid destruction of the foot.

3. It is possible to detect early stages of this condition in time to take preventive measures. Routine palpation of anaesthetic feet will reveal patches of warmth localised to bones and joints which are in a condition of strain. Radiographs of such feet and a study of posture and gait may define early changes which point to one of several possible patterns of disintegration which may follow.

4. These patterns are described and discussed and suggestions made for preventive and corrective measures.
PSEUDOGOUT SIMULATING ACUTE SUPPURATIVE ARTHRITIS
Authors: Hamblen D. L. , Currey H. L. F. , Key J. J.
Published: February 2018

1. Two cases of pseudogout are described with an onset acute enough to be mistaken for septic arthritis.

2. The radiological and laboratory investigations for diagnosis are described.
ACUTE CALCIFIC SYNOVITIS OF THE KNEE
Authors: Mann T. S.
Published: February 2018

1. Five elderly patients who suffered acute synovitis of one or both knee joints are reported.

2. All showed radiological evidence in several joints of cartilage calcification.

3. It is suggested that the synovitis in each case was due to calcium irritation of the synovial membrane.

4. In three of the patients it is shown that the synovial fluid calcium content was raised during the acute attack.

5. In all patients acute symptoms were relieved by aspiration of the effusion.
REPLACEMENT OF ARTHRITIC HIPS BY THE McKEE-FARRAR PROSTHESIS
Authors: McKee G. K. , Watson-Farrar J.
Published: February 2018

1. The various surgical procedures in common use for the treatment of the osteoarthritic hip are briefly reviewed and compared with the operation of replacement of both the acetabulum and head of the femur by a metal prosthesis, that is, a complete artificial hip joint.

2. The development, description and technique of insertion of this artificial hip joint are given in detail.

3. The results of the first fifty cases of this operation show a success rate of over 90 per cent. The few failures are analysed in detail. The revision procedure has been the insertion of another artificial hip joint.

4. The essential details necessary for success are stressed and the indications and aims of the operation given.
JUXTA-EPIPHYSIAL FRACTURE OF THE TERMINAL PHALANX OF THE FINGER
Authors: Seymour N.
Published: February 2018

The treatment of juxta-epiphysial fractures of the terminal phalanx is discussed. It is submitted that a simple form of conservative treatment gives the best results.
ARTHROGRAPHY OF THE SHOULDER
Authors: Reeves Brian
Published: February 2018

1. Arthrography demonstrates two types of injury to the capsule in acute anterior dislocations of the shoulder.

2. The first is a capsular rupture which does not appear to lead to recurrent dislocation of the shoulder unless there is concomitant humeral head damage. In this group healing is complete in ten days and it should be safe to start exercises early.

3. The second is associated with labral detachment from the glenoid and most heal with immobilisation for three weeks. Failure to heal leads to recurrent dislocation. It is not known whether immobilisation had any influence on healing of the lesion in these patients and this remains the subject of further investigation.

4. In recurrent anterior dislocation of the shoulder there is constant enlargement of the subscapular bursa, the outline of which becomes continuous with the inferior pouch. Axial arthrographs show either an absence of the glenoid labral outline or an enlarged entrance to the subscapular bursa.

5. Ruptures of the supraspinatus portion of the tendinous cuff were seen in five patients out of a total of twenty-seven acute dislocations, suggesting that this associated injury is more common than was previously believed.

POSTERIOR DISLOCATIONS

6. When the dislocation is voluntary there is marked elasticity of the capsule but the joint is only unstable in one direction when examined under anaesthesia. Both shoulders appear equally affected when examined radiologically under general anaesthesia even though the patient only has the ability to dislocate one.

7. All patients with voluntary dislocation had a curious voluntary muscle control and were able to contract the anterior and posterior parts of deltoid separately. Each dislocation was preceded by scapular movement.

8. No evidence of increased joint laxity was found in other joints in any of the patients.

9. In two patients with acute dislocations the defect of the humeral head was seen after the initial dislocation and in the third patient it occurred at the time of the second dislocation. In all three there was a spill of fluid beneath the subscapularis but no leakage into the axilla as occurred in anterior dislocation with capsular rupture. The capacity for healing appeared greater than in anterior dislocations with labral detachment; one patient treated in a sling had a better functional result than another treated with the shoulder in lateral rotation.
BIRTH INJURY TO THE STERNOMASTOID MUSCLE
Authors: Sanerkin N. G. , Edwards Padma
Published: February 2018

1. A case is described of severe birth injury to the sternomastoid muscle in a breech-delivered two-day-old infant. The affected muscle showed widespread haemorrhage, fragmentation and necrosis of its fibres, and disruption and disorganisation of the endomysial sheaths.

2. Disruptive muscular trauma of this type is known to lead to florid fibroblastic proliferation with formation of a large mass of scar tissue. It is suggested that the "sternomastoid tumour" of infancy develops as a sequel to such trauma occurring during birth.

3. The theories of birth trauma and of ischaemia, in the etiology of the "sternomastoid tumour" of infancy and of congenital muscular torticollis, are not mutually exclusive but may be complementary, the circumstances causing the trauma also leading to ischaemic damage.
OSTEOID OSTEOMA
Authors: Rosborough D.
Published: February 2018

1. A case of an osteoid osteoma in the terminal phalanx of a finger is recorded.

2. Unusual features were enlargement of the finger with nail hypertrophy, sweating, and premature fusion of the epiphysis.
ECTOPIC BONE FORMATION ASSOCIATED WITH MULTIPLE CONGENITAL ANOMALIES
Authors: Rosborough D.
Published: February 2018

1. A patient with ectopic bone in the upper arm associated with multiple congenital anomalies is reported.

2. The previous cases of congenital abnormalities in patients with ectopic bone formation have been indicated and the problem of etiology has been discussed.
FRACTURE OF THE LOWER END OF THE RADIUS WITH ULNAR NERVE PALSY
Authors: Zoëga H.
Published: February 2018

1. Three cases of Colles's fracture complicated by ulnar nerve paralysis are described.

2. Observation at operation in two cases and studies in a cadaver demonstrated a close relationship of the ulnar nerve to a fracture line at the lower end of the radius when the distal fragment is displaced dorsally and radially. It is surprising that this injury has not been observed and commented on previously.
ELECTRON-PROBE MICROANALYSIS OF TISSUE AND CELLS FROM IMPLANT AREAS
Authors: Mears D. C.
Published: February 2018

1. Electron-probe microanalysis shows that corrosion of an 18 per cent chromium-8 per cent nickel-3 per cent molybdenum stainless steel implant and of some pure metal implants may affect not only the surrounding tissues but also the individual cells.

2. Metallic contamination from surgical tools is confirmed.

3. Electron-probe microanalysis is shown to be a useful tool for studying individual biological cells.

4. The principles of electron-probe microanalysis are described.
EPIDERMAL CYSTS OF PHALANGES
Authors: Byers Paul , Mantle John , Salm René
Published: February 2018

1. Four cases of epidermal cysts of the terminal phalanges of the fingers are reported.

2. The literature is reviewed and the etiological factors discussed.
POSTERIOR INTEROSSEOUS NEURITIS
Authors: Sharrard W. J. W.
Published: February 2018

1. Six patients suffering from spontaneous posterior interosseous paralysis are described.

2. Two were due to benign tumour and four due to traumatic neuritis, three of which were associated with minor hyperextension injuries to the elbow joint and one with long standing cubitus varus.

3. Surgical exploration was performed in each patient with recovery of nerve function.
THE BASIC ANATOMY OF SCOLIOSIS
Authors: Roaf Robert
Published: February 2018

1. Evidence is presented that the basic lesion in scoliosis is relative lengthening of the anterior components of the spine compared with the posterior elements.

2. The logical treatment is to reduce this relative lengthening either by lengthening the posterior elements or shortening the anterior elements. This may be achieved by anterior lumbar wedge osteotomy or by epiphysiodesis; and correction of lumbar lordosis can improve a thoracic scoliosis.
PERTHES' DISEASE
Authors: Ratliff A. H. C.
Published: February 2018

1 . Thirty-four cases of Perthes' disease followed into adult life were reviewed twenty-five to forty years (average thirty years) after diagnosis.

2. Rather more than one-third of the patients developed hips which were good, an equal number were considered fair and about one-quarter were poor.

3. Four out of five patients were fully active and free from pain but only two out of five had hips which were radiologically good.

4. Clinical and/or radiological deterioration had seldom occurred in the last twelve years.

5. A good result in childhood is likely to be maintained with no pain and good function up to the age of forty years and perhaps longer.
OSTEOCHONDRITIS DISSECANS FOLLOWING LEGG-CALVÉ-PERTHES' DISEASE
Authors: Ratliff A. H. C.
Published: February 2018

1 . Two cases of osteochondritis dissecans after Legg-Calvé-Perthes' disease observed for thirty years are described.

2. Osteochondritis dissecans of the hip can remain in an apparently unchanged state for many years and in these two patients is associated with excellent function, not requiring surgery.
GENU RECURVATUM CONGENITUM
Authors: Laurence Michael
Published: February 2018

1. Thirty-two infants with genu recurvatum congenitum are reported.

2. Fifteen infants responded completely within eight weeks with conservative treatment; the remaining cases were recalcitrant.

3. The etiology, pathology and treatment of the two groups are discussed.

4. The prognosis is adversely affected by delay in treatment by the presence of certain associated deformities and by generalised joint laxity.

5. Indications for operative treatment are suggested.
AN EXPERIMENTAL COMPARISON OF LIVING AND DEAD BONE IN RATS
Authors: Stevens Jack , Ray Robert D.
Published: February 2018

1. The distribution of isotope following a single injection of either Ca45 or C14-proline has been studied in young rats in which one tibia had previously been removed, killed and reimplanted.

2. The dead tibia took up about 25 per cent as much Ca45 or C14 as did the living tibia and the possible processes by which this occurred are discussed.

3. Determination of the "accretion rate " by kinetic analysis of the Ca45 data showed that this was much too high unless the physico-chemical process of uptake of isotope by bone was taken into account.

4. Under the conditions of the experiment it was not possible to estimate the rate of bone matrix formation using C14-proline as a tracer.
SMOOTH MUSCLE TUMOURS OF THE LIMBS
Authors: Bulmer J. H.
Published: February 2018

1. Clinical and histological features in ten patients with smooth muscle tumours of the limbs are described.

2. Severe pain and tenderness and the radiographic demonstration of calcification are useful pointers to the diagnosis.

3. Local recurrence of the tumour occurred in four patients despite apparently adequate excision. In three of these the tumours were shown histologically to be benign.
A NEW OPERATION FOR CONGENITAL ABSENCE OF THE FIBULA
Authors: Serafin Jan
Published: February 2018

1. In congenital absence of the fibula, the fibrous strip that replaces the bone, abnormal insertions of fibular muscles, and disturbances in the formation and growth of the tarsal bones all go to cause the valgus deformity of the foot and the complete or partial dislocation of the talo-tibial joint.

2. Conservative treatment is justified only for children less than a year old and then only as preparation for operation.

3. Between the second and seventh year of life operations upon the soft tissues are indicated, to eliminate the contractures occurring on the posterior and lateral sides, to restore the proper position of the foot in line with the axis of the tibia, and to restore the normal shape of the foot and muscular equilibrium. At the same time favourable conditions are created for operative reconstruction of the lateral malleolus.

4. Arthrodesis of the talo-tibial joint or reconstruction of the lateral malleolus by a bone graft with the aim of stabilising the foot in the axis of tibia is not advisable in the growing limb.

5. The results obtained in three cases described support the conclusion that the bifurcation operation recommended by Gruca produces a new lateral malleolus with an epiphysis that grows at the same rate as the remainder of the lower epiphysis of the tibia, does not affect the rate of growth of the tibial epiphysis, prevents the recurrence of the deformity, and preserves the mobility of the talo-tibial joint.

6. In early cases this reconstructive operation may be done at the same time as soft-tissue deformities are corrected and subluxation reduced.

7. It is probable that the bifurcation operation should be done on children aged between two and seven years in order to give the limb the best chance to develop normally.
TRANSPLANTATION OF THE HAMSTRING MUSCLES IN CEREBRAL PALSY
Authors: Pollock G. A. , English T. A.
Published: February 2018

1 . A ten-year study of fifty-four operations for transplantation of the hamstring muscles in thirty-one spastic patients has been made.

2. Twenty-one patients were improved after operation, six were not improved, and in four the duration of follow-up was too short for proper assessment. One patient died from other causes.

3. Greatest benefit was not obtained until one year after operation.

4. The results varied considerably in different grades of spastic patient. Important factors affecting the results were age, sex, personality, balance and function of arm and hip. Hand and major hip operations should be carried out before hamstring transplantation.

5. The objectives of operation are discussed. These were most consistently achieved in older, more ambitious or more responsible males with good balance and with good arm and hip function.

6. Factors which were of less direct importance were mental capacity, minor degrees of limb length inequality, and foot deformities.

7. Operative correction of foot deformities should not be done before hamstring transplantation.

8. Serial plaster correction of the knee flexion deformity before operation is preferred to division of the patellar retinacula.

9. Transplantation of the hamstrings to the patella in spastics is under trial.
ARTHRODESIS OF THE SUBTALAR JOINT
Authors: Thomas F. Brian
Published: February 2018

1. A modification of the Grice extra-articular subtalar arthrodesis is described.

2. The results of this operation are presented.
UNREDUCED ANTERIOR DISLOCATION OF THE HIP
Authors: Aggarwal N. D. , Singh Hardas
Published: February 2018

1. Seven cases of old unreduced anterior dislocation of the hip are reported. Six were complicated by myositis ossificans.

2. Four cases resulted from the fall of a heavy object on the lower back of a stooping person.

3. Trochanteric osteotomy in five cases not only corrected the deformity but gave stable, serviceable hips.
VENOUS DRAINAGE IN OSTEOARTHRITIS OF THE HIP
Authors: Phillips R. S. , Bulmer J. H. , Hoyle G. , Davies W.
Published: February 2018

1. Thirty-seven hips with osteoarthritis underwent phlebography before intertrochanteric osteotomy. The results of this study were reported previously.

2. Thirty-two of the hips were studied and have had a clinical, radiological and phlebographic examination about one year after operation. Three of these were excluded because of technical failures.

3. Twenty-four hips had a normal pattern of venous drainage after operation; of these only two had normal patterns before operation and the rest had had many abnormalities of venous drainage. These hips had been completely or considerably relieved of pain at rest and on activity.

4. In the other five hips, although the venous drainage pattern was still abnormal, in only one was there significant deterioration in the venous pattern; in this group there was also some alleviation of rest pain.

5. The findings are discussed in relation to the pathology of osteoarthritis and the possible influences of intertrochanteric osteotomy.

6. The pain produced by the injection of radiopaque material into the femoral head was similar to the rest pain. This finding is discussed in relation to venous obstruction and congestion.
SHIN SPLINTS, OR STRESS FRACTURES OF THE METACARPAL BONE IN HORSES, AND SHIN SORENESS, OR STRESS FRACTURES OF THE TIBIA, IN MAN
Authors: Devas M. B.
Published: February 2018

1. Shin splints in five horses is described as a stress fracture of the second metacarpal bone.

2. The value of this finding in relation to stress fracture of the tibia in man is discussed.
THE ANATOMY OF THE VOLAR PART OF THE CAPSULES OF THE FINGER JOINTS
Authors: Gad Palle
Published: February 2018

1. A method of finger dissection is described which provides a new approach to the anatomical study of structures in close relation to joints.

2. The volar part of the capsule of the finger joints is described, the attachment to the bones being particularly emphasised together with its form which is like that of a meniscus.

3. A gap between bone and tendon sheath is described.

4. Theoretical and clinical aspects of the local anatomy are discussed.
THE Z-PLASTY IN HAND SURGERY
Authors: McGregor Ian A.
Published: February 2018

1. The modifications of standard Z-plasty technique that are necessary for its successful use in hand surgery are discussed with particular reference to the limiting factors imposed by the anatomical characteristics of the hand.

2. The use of the Z-plasty in Dupuytren's contracture and contracted scars is discussed.
DIAGNOSIS AND TREATMENT OF LUMBAR INSTABILITY
Authors: Lettin A. W. F.
Published: February 2018

1. The clinical features in nineteen patients with structural defects of the pars interarticularis are compared with the findings in twenty-two patients with degenerative changes in the lumbar spine, and are shown to be essentially the same.

2. It is suggested that both structural defects and degenerative changes give rise to mechanical instability of the lumbar spine. This puts an increased load on the posterior vertebral soft tissues and gives rise to a characteristic picture, the features of which are described.

3. The signs and symptoms of root compression may be superimposed on this picture, and when this is the case, decompression of the nerve roots should be undertaken in addition to spinal fusion, which is suggested as the logical treatment.

4. After fusion, with decompression when indicated, 50 per cent of the patients were completely relieved of their symptoms and 87 per cent derived worthwhile benefit.
MONARTICULAR BRUCELLAR ARTHRITIS IN CHILDREN
Authors: Adam A. , Macdonald A. , Mackenzie I. G.
Published: February 2018

1. Eight cases of monarticular brucellar arthritis in children are described. They have been followed up from between one and six years and all are now fully active and clinically normal.

2. The history was usually short, with limp, swelling of the joint and pain as the presenting symptoms. Constitutional disturbance was slight in all cases.

3. Diagnosis was confirmed by high concurrent serum agglutinin titres which were not found in control children of the same age from the same areas. Mercaptoethanol resistant antibody (IgG) and complement fixing antibodies were also demonstrated in the sera of four cases. One child had a positive blood culture.

4. The condition responded rapidly to rest and splintage and, to date, recovery seems to have been complete.
CONGENITAL SHORT TENDO CALCANEUS
Authors: Hall J. E. , Salter R. B. , Bhalla S. K.
Published: February 2018

1. Twenty patients with congenital short tendo calcaneus are described.

2. All were treated by tendon lengthening and followed up for one and a half to seven years.
OBSERVATIONS ON THE FATE OF FIBULAR TRANSPLANTS FOR CONGENITAL ABSENCE OF THE RADIUS
Authors: Blockey N. J.
Published: February 2018

There is some radiological, clinical and histological evidence to show that a fibular graft inserted into the forearm may continue to grow.
INFANTILE SUPRACONDYLAR FRACTURE
Authors: Macafee A. L.
Published: February 2018

Three cases are described of elbow injuries in infants, to illustrate the difficulty of differentiating a dislocation from a supracondylar fracture.
VARIATION IN THE DENSITY OF THE FEMORAL DIAPHYSIS WITH AGE
Authors: Atkinson P. J. , Weatherell J. A.
Published: February 2018

1. A detailed study of density variations with age in cortical bone samples from different areas of the femoral diaphysis has been carried out.

2. Bone of relatively high density and, conversely, of low density was found to have a spiral pattern along the bone shaft.

3. Moving distally along the femoral shaft there was a transposition of the greatest density from the anterior to the posterior aspect.

4. In the erect body posture the femoral inclination is such that areas of denser bone might be expected to be aligned vertically because of the weight-bearing characteristics of the femur.

5. Most areas of the cortex tended to decrease in density after the age of fifty, the less dense areas changing more than those with an initial high density. Thus, osteoporosis tended not only to maintain but to accentuate the spiral pattern of density distribution by increasing the difference between dense and less dense bone.

6. In the distal region of the diaphysis bone resorption was greatest anteriorly but hardly affected the posterior aspect. A densitometric comparison between these two sites provided a clear indication of the effect of osteoporosis.
ANEURYSMAL BONE CYSTS
Authors: Clough J. R. , Price C. H. G.
Published: February 2018

1. The clinical, radiological, operative and histological features of twelve aneurysmal bone cysts are recorded.

2. Attention is drawn to atypical features, and the problem of diagnosis is discussed.

3. It is recommended that treatment should be complete excision, except where this would interfere with function.

4. Various theories on pathogenesis are considered and favour given to the view that these cysts result from a local change in haemodynamics occurring possibly in a pre-existing lesion.
A VARIANT OF THE MOTOR BRANCH OF THE MEDIAN NERVE IN THE HAND
Authors: Papathanassiou Basil T.
Published: February 2018

A variation of the motor branch of the median nerve is described in which this branch arose more proximally and pierced the flexor retinaculum. Its significance during a carpal tunnel decompression is pointed out.
MEASUREMENT OF THE RATE AND DISTRIBUTION OF THE NUTRIENT AND OTHER ARTERIAL BLOOD SUPPLY IN LONG BONES OF THE RABBIT
Authors: Shim Sun Shik , Copp D. Harold , Patterson Frank P.
Published: February 2018

1. Hitherto, no study has been reported on the relative quantitative contributions of blood supply by the different arterial systems of long bone. This paper is a report on such a study in the young adult rabbit.

2. The rates and regional distributions of the blood supply of the nutrient as well as other arteries of the femur were studied after ligation of the nutrient artery. The average rates of reduction in blood flow per minute for the first five minutes through the entire femur as well as the shaft, and the epiphysis and metaphysis on each end, were measured and analysed. The bone blood flow was measured by the method of bone clearance of blood strontium 85.

3. The normal average rate of blood flow through the femurs of average weight of 9·38 grammes was 0·90±0·05 millilitres per minute, or 9·60±0·47 millilitres per minute per 100 grammes of bone.

4. The nutrient artery contributed at least 46 per cent of the normal total blood supply of the entire femur and at least 71 per cent of the normal total blood flow of the shaft including its marrow, and 37 per cent and 33 per cent of the normal total blood flow of the upper and the lower epiphysial and metaphysial areas respectively.

5. About 63 per cent, 30 per cent and 67 per cent of the total normal blood flow through the upper epiphysis and metaphysis, the shaft and the lower epiphysis and metaphysis respectively are still intact in the first five minutes after ligation of the nutrient artery, which represent the approximate proportions of the blood supply by the other regional arteries.

6. These quantitative data obtained in this study offer good support to the qualitative observations made by many previous workers.
OLD LUXATIONS OF THE LOWER CERVICAL SPINE
Authors: Braakman R. , Vinken P. J.
Published: February 2018

1. In thirty-six out of seventy-two cases of cervical vertebral interlocking, luxation was still present after two weeks ("old luxation"). The principal reasons for overlooking the diagnosis are lack of familiarity with the radiographic appearances and incomplete or inadequate radiographic examination.

2. Failure to identify luxation probably hardly influences the prognosis of the immediate cord lesion; but recovery from the radicular lesion is unfavourably affected, and a progressive cord lesion may occur later when none previously existed.

3. Reduction is advisable if the luxation is not more than six weeks old. Operative reduction is preferred; manual reduction under anaesthesia and caliper traction with heavy weights are less satisfactory alternatives. Reduction is contra-indicated if the luxation is more than six weeks old.

4. Indications for fixation and the choice between internal and external (plaster jacket) fixation are discussed, and also the treatment of stable lesions which have not been reduced.
BUTLER'S OPERATION FOR AN OVER-RIDING FIFTH TOE
Authors: Cockin J.
Published: February 2018

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.
SOLITARY MYELOMA OF THE SPINE
Authors: Valderrama J. A. F. , Bullough Peter G.
Published: February 2018

1. Of forty-seven patients with histologically proven myeloma of the spine, thirty-three had multiple lesions at the time of the first examination and fourteen were solitary.

2. Five of the solitary cases, in which the patients are alive and well without signs of dissemination four to fourteen years after diagnosis, are considered in detail and the differences in clinical presentation and prognosis are discussed.

3. A sixth case, described in detail, showed scattered osteolytic lesions after ten years.
DISTAL MIGRATION OF THE FEMORAL INTRAMEDULLARY NAIL
Authors: de Belder K. R. J.
Published: February 2018

1. Distal migration of a femoral intramedullary nail is described in seven patients. Previous reports of proximal and distal migration are reviewed.

2. Factors predisposing to this complication are infection, incorrect nail size, comminution of the fracture and involvement of the medullary isthmus.
LESIONS OF THE FLEXOR CARPI RADIALIS TENDON AND SHEATH CAUSING PAIN AT THE WRIST
Authors: Fitton J. M. , Shea F. W. , Goldie W.
Published: February 2018

1. Pain at the front of the radial side of the wrist may be caused by various lesions of the tendon and sheath of the flexor carpi radialis tendon.

2. The diagnosis may be established by testing resisted movement at the wrist and by the effect of injecting local anaesthetic into the tendon sheath.

3. In women over the age of fifty the lesion is associated with osteoarthritis of the joint between the scaphoid and the trapezium.

4. Osteoarthritis of the joint between the scaphoid and the trapezium is found in about 25 per cent of women over the age of fifty.

5. If the pain is not relieved by simple conservative measures it can usually be cured by incision of the tendon sheath.

6. The histological changes in the tendon sheath are similar to those found in tenovaginitis of the abductor pollicis longus and tibialis posterior tendons.
A MODIFICATION OF THE GRICE SUBTALAR ARTHRODESIS
Authors: Seymour N. , Evans D. K.
Published: February 2018

1. The Batchelor method of subtalar fusion by a fibular graft inserted through the neck of the talus is described.

2. The results of the operation appear to be satisfactory.
THE USE OF CYTOTOXIC DRUGS IN THE SURGERY OF MALIGNANT DISEASE
Authors: Watt J.
Published: February 2018

1. The history of cytotoxic treatment has been briefly reviewed.

2. The structure and possible mode of action of the various agents have been described.

3. The applications, techniques and complications of cytotoxic treatment have been discussed.
EARLY OR DELAYED WEIGHT-BEARING AFTER INTERNAL FIXATION OF TRANSCERVICAL FRACTURE OF THE FEMUR
Authors: Graham James
Published: February 2018

1. A report is presented of the results of a trial to compare the effects of early and late weight-bearing in patients with a transcervical fracture of the femur treated by reduction of the fracture and internal fixation with a sliding nail-plate.

2. One hundred and twelve patients have been assessed clinically and radiologically three years after operation.

3. Retrospective analysis of factors that affect the outcome of treatment suggests that the two groups were fairly evenly balanced.

4. The results show that full weight-bearing two weeks after operation did not increase the incidence of failure of fixation or of non-union.

5. The higher incidence of superior segmental collapse in patients in whom weight-bearing was deferred for twelve weeks can be explained by the greater number of high fractures in this group and the greater number with a poor reduction.
BILATERAL CALCAREOUS BURSITIS AT THE ELBOW
Authors: Vizkelety Tibor , Aszodi Karoly
Published: February 2018

1. A case of symmetrical bilateral calcareous bursitis at the elbow is described.

2. Metabolic and neurotrophic factors played a role in its genesis.

3. Chemical analysis showed a similarity between the ratio of calcium phosphate and calcium carbonate in dystrophic calcification and in the fluid in the bursal cavity.

4. An inflammatory reaction was seen around the calcium appearing interstitially: this was probably not a consequence of chemical stimuli.
THE ARCADE OF FROHSE AND ITS RELATIONSHIP TO POSTERIOR INTEROSSEOUS NERVE PARALYSIS
Authors: Spinner Morton
Published: February 2018

1. The arcade of Frohse, a fibrous arch over the posterior interosseous nerve, may well play a part in causing progressive paralysis of the posterior interosseous nerve, both with and without injury.

2. Paralysis of the muscles supplied by this nerve with no evidence of recovery after six weeks, either electromyographic or clinical, should be treated by exploration and splitting of the arcade of Frohse.
SURGICAL TREATMENT OF MANUBRIO-STERNAL PAIN IN BEHÇET'S SYNDROME
Authors: Currey H. L. F. , Elson R. A. , Mason R. M.
Published: February 2018

1. A case of Behçet's syndrome in which the main complaint was severe pain in the manubrio-sternal joint is described. Arthrodesis relieved the pain.

2. Histological material from a mouth ulcer and from the manubrio-sternal joint showed non-specific inflammatory changes but failed to throw light on the etiology.