bluuebunny/crossref_metadata_2025 huggingface dataset:
THE ETIOLOGY OF HYPEROSTOSIS CRANII (METABOLIC CRANIOPATHY)
Authors: Caughey J. E.
Published: February 2018

1. The clinical features of hyperostosis cranii are briefly reviewed. In large series of cases the syndrome has been found to occur almost entirely in females.

2. In recent studies of dystrophia myotonica, it is apparent that hyperostosis cranii is one of the variable features of the disorder. This disease occurs equally among males and females and the hyperostosis cranii also is distributed equally among males and females.

3. Hyperostosis cranii also occurs in patients with Morgagni's syndrome, with acromegaly, and as "senile hyperostosis."

4. The etiology of hyperostosis is still a matter for speculation. More recent studies have focused attention on the endocrine system, and it seems probable, in view of the sex distribution in dystrophia myotonica, that the key to the problem may be found in this disorder.

5. In dystrophia myotonica the characteristic skull changes are hyperostosis cranii, a small pituitary fossa, excessive sinus formation and prognathism. These are acromegaloid changes. Gonadal atrophy is a common feature and endocrine study suggests that the endocrine defect is primarily a failure of the androgenic function of the adrenals and the testes.

6. In rodents and in humans ablation of the gonads leads to overactivity of gonadotrophic cells and, at times, of somatotrophic cells. Sometimes pituitary tumours develop.

7. Acromegaloid features may occur in eunuchs, and it is likely that the acromegaloid changes in dystrophia myotonica are of the same order from overactivity of growth hormone.

8. In animals excess of growth hormone produces thickening of the skull.

9. In dystrophia myotonica, acromegaly, and Morgagni's syndrome, it is suggested that hyperostosis cranii is an expression of unrestrained activity of growth hormone.
THE OSSIFICATION AND VASCULARISATION OF THE TARSAL NAVICULAR AND THEIR RELATION TO KOÌHLER'S DISEASE
Authors: Waugh W.
Published: February 2018

1. Serial radiographs of fifty-two normal children's feet, taken at six-monthly intervals between two and five years, have been reviewed.

2. Twenty-one naviculars have been injected post-mortem and the vascularisation of the growing bone investigated.

3. The records of sixty-two children with a diagnosis of KoÌhler's disease have been studied.

4. It is submitted that abnormal ossification results from compression of the bony nucleus at a critical phase during growth of a navicular bone whose appearance is delayed.

5. Symptoms in KoÌhler's disease are related to further compression which produces vascular changes in the bony nucleus. Consequent ischaemia is followed by hyperaemia which produces local pain, tenderness and swelling.

6. Two radiographic types of KoÌhler's disease are described and attributed to variations in the basic vascular pattern of the affected bone.

7. The usual complete recovery of the navicular is ascribed in part to the basic arrangement of numerous radially penetrating vessels.
BONDING OF FRACTURES BY PLASTIC ADHESIVES
Authors: Bloch Bernard
Published: February 2018

1. The properties and behaviour of ethoxyline resins, which are already well known in industry, are discussed.

2. Experiments in the use of these compounds for the bonding of fractures of the long bones of sheep are described.

3. There has been no evidence of toxic reaction to the presence of the resin in the tissues.

4. Application of the method to fractures in man has been studied, and two such fractures have been bonded with promising early results.
PECTORAL TRANSPLANTATION FOR PARALYSIS OF THE FLEXORS OF THE ELBOW
Authors: Brooks D. M. , Seddon H. J.
Published: February 2018

We believe that this technique has several advantages. After poliomyelitis recovery in the clavicular head of pectoralis major may exceed that in the sternal head; there may be considerable but incomplete recovery in both heads and it is then desirable to use all the active muscle available. Girls and women dislike conspicuous scars; the incisions used in this technique are unobtrusive when the arm is by the side.
A CASE OF REPLACEMENT OF THE UPPER END OF THE HUMERUS BY A FIBULAR GRAFT REVIEWED AFTER TWENTY-NINE YEARS
Authors: Clark Kenneth
Published: February 2018

1. A case of giant-cell tumour of the proximal end of the humerus treated by resection and fibular grafting twenty-nine years ago is reported. An excellent functional result has been maintained.

2. The literature is reviewed and the results claimed by earlier workers are noted.

3. The present field of application of the operation is probably in cases of advanced or recurrent giant-cell tumour of bone.
EXTERNAL COUNTING OF Ca47 AND Sr85 IN STUDIES OF LOCALISED SKELETAL LESIONS IN MAN
Authors: Bauer Göran C. H. , Wendeberg Bo
Published: February 2018

1. Based on studies in seventy-five patients, a technique is described for body surface activity measurements over localised skeletal lesions up to one month after injection of the λ-emitting isotopes Ca47 and Sr85.

2. The activity was high over skeletal lesions like fracture, metastatic cancer, eosinophilic granuloma, chondroma, osteomyelitis and Paget's disease.

3. The high isotope uptake is interpreted as evidence of an increased rate of bone tissue turnover.

4. These findings suggest that external counting of Ca47 and Sr85 may be used for quantitation of the rate of formation of normal and pathological bone tissue. A special application would be localisation and delineation of metastatic cancer in cases where radiographic evidence is uncertain or non-existent.
OBSERVATIONS ON THE MANIFESTATIONS OF OSTEOLATHYRISM IN THE CHICK
Authors: Bélanger Leonard F.
Published: February 2018

1. Severe osteolathyrism has been induced in chicks of different ages by a diet containing 50 per cent seeds of Lathyrus odoratus.

2. In these chicks, most of which became paraplegic after seven days, a meningeal tumour, articular and bony deformities, spontaneous fractures and osteoporosis have been observed.

3. In cartilage the lesion involves depletion of both neutral and acidic polysaccharides.

4. The primary effect on bone consists of changes in the osteoblasts and in the osteocytes involving cytoplasmic granulation and vacuolation, "mineralisation" and eventual disintegration of the cells.

5. These events are followed by osteoporosis. abnormal mineral deposits in the marrow spaces and reactive callus-like activation of the periosteum.

6. The role of the osteoblast and of the osteocyte in mineral transit and deposition is reconsidered.
THE TROCHANTERIC RECONSTRUCTION OPERATION FOR UNUNITED FRACTURES OF THE UPPER END OF THE FEMUR
Authors: Colonna Paul C.
Published: February 2018

I have attempted to call attention briefly to an operation that has proved to be of use in many patients with non-union of the neck of the femur and have tried to point out not only the indications but also the contra-indications, and to stress some of the precautions in the technique and after-care of the operation. This trochanteric reconstruction operation may help to solve some of the problems related to the ununited hip fracture.
ARTHRODESIS OF THE WRIST IN RECONSTRUCTIVE SURGERY
Authors: MacKenzie I. G.
Published: February 2018

1. A medial approach is preferred for arthrodesis of the wrist in reconstructive surgery because there is no interference with the extensor tendons.

2. The value of pre-operative assessment by a trial period in plaster is mentioned.

3. The technique of operation is described.

4. In the absence of active pronation, screwing the ulna to the radius in 45 degrees of pronation is advised.

5. The necessity for securing haemostasis before closing the wound is emphasised.

6. Thirty-four cases are reviewed. The shortest follow-up was one year and the longest twelve years. The result was satisfactory in all cases. Most patients were discharged from hospital after the plaster had been changed two weeks after operation. Union occurred in about sixteen weeks.
STRESS FRACTURES OF THE PATELLA
Authors: Devas M. B.
Published: February 2018

Case histories are given of three patients, two of whom had stress fractures of the patella, and one had a similar condition due to stress.
HAEMANGIOPERICYTOMA: ITS ORTHOPAEDIC MANIFESTATIONS
Authors: Kennedy J. C. , Fisher John H.
Published: February 2018

1. Nine cases of haemangiopericytoma are described and the treatment is discussed.

2. Six of the patients had a recurrence of the tumour after local excision.

3. Four patients developed metastases and died. All had been treated by surgery and cobalt 60 beam radiation.

4. Five of the patients show no further disease. Of these, two received cobalt 60 beam radiation after surgical treatment.
ACUTE PYOGENIC INFECTIONS OF THE SPINE IN CHILDREN
Authors: Pritchard A. E. , Thompson W. A. L.
Published: February 2018

1. Six children suffering from acute infections of the spine have been studied.

2. Clinical and radiographic features are described. Reasons are given for bearing the condition in mind when dealing with cases of pyrexia of unknown origin in children.

3. Treatment is broadly outlined.

4. Radiographic findings are discussed in relation to the pathology of the disease.
SIMULTANEOUS BILATERAL FRACTURES OF THE NECK OF THE FEMUR
Authors: Powell H. D. W.
Published: February 2018

Cases are reported of two men who sustained bilateral hip injuries while undergoing convulsive therapy and of one woman who sustained bilateral hip injuries during a uraemic convulsion. A further twenty-three previously unreported cases are analysed, sixteen of which were of simultaneous bilateral femoral neck fractures and five of which were simultaneous bilateral central dislocations of the hip. One other patient sustained his injuries in an epileptic fit. A review of the literature has revealed another thirty-five cases of bilateral hip injuries, most of them caused by convulsive therapy, but a few by accident, disease of the femoral neck, or epilepsy.

One case is included of a rare double injury, a femoral neck fracture on one side and a central dislocation on the other. I have found no previous reference to this combined injury.

Double hip injuries are very rare in relation to the large numbers of patients receiving convulsion therapy, but the change from pharmacological to electrical methods has not prevented their occurrence and at least fifteen are known to have occurred during the last six years.

A wide age range is represented, and many fractures of convulsive origin have occurred in fit, well nourished, adult men. Only a few have been found in more elderly and possibly osteoporotic patients.

All the "convulsive " injuries were sustained during unmodified treatment, and mention is made of the differences of opinion among psychiatrists about the use of anaesthesia and of relaxant drugs in convulsion therapy.

These are the most severe injuries complicating convulsion therapy, and the most difficult for the orthopaedic surgeon to treat.
PRIMARY SUBTALAR ARTHRODESIS IN THE TREATMENT OF SEVERE FRACTURES OF THE CALCANEUM
Authors: Hall Michael C. , Pennal George F.
Published: February 2018

1. The history of open operations on fractures of the calcaneum is reviewed.

2. A report is given of the results of treatment of comminuted and depressed fractures of the calcaneum by primary arthrodesis by a modified Gallie procedure.

3. Of twenty-nine patients, twenty-seven returned to full employment within an average of 6·4 months. Twenty-five of these returned to their previous jobs.

4. Poor tendo calcaneus function and lateral sub-malleolar pain were found to be closely allied; both complaints were absent in the usually successful case and occurred only where there had been some complication.

5. It is contended that subtalar arthrodesis is a successful method of treatment for this fracture, but that the operation should be performed soon after the injury in order that the deformity may be corrected.
RECONSTRUCTION OF THE THUMB
Authors: Reid D. A. Campbell
Published: February 2018

1. Absence of a thumb, whether congenital or due to injury, is a severe disability. Reconstructive surgery has much to offer.

2. Pollicisation is the most satisfactory method, being the only means of providing a thumb with normal tactile sensibility. The importance of this has often been overlooked and has been emphasised by Moberg (1958). Pollicisation offers also the best functional and aesthetic results. When applicable, the neurovascular pedicle technique of Littler is the one of choice. It is indicated in group 2 cases associated with a partly amputated finger, when this is swung on to the thumb stump, and for patients in groups 3 and 4 when the normal index finger is used. If this method is not feasible a staged pollicisation may be used instead.

3. The Gillies method of thumb lengthening has a more limited application, but it is valuable in selected cases.

4. Reconstruction by tubed pedicle and bone graft is seldom indicated and is best reserved for reconstruction in the mutilated hand when local elements are deficient.

5. Replacing a thumb by a toe should be reserved for exceptional cases.

6. Autografting the amputated thumb is feasible, and should be considered when the amputated digit has been preserved.
TREATMENT OF INEQUALITY OF THE LOWER LIMBS
Authors: Tupman G. S.
Published: February 2018

1. The results are reported of a series of operations designed to stimulate growth of the bones of the lower limb by the insertion of pegs of bone or ivory close to the epiphysial cartilage.

2. The evidence is that growth was stimulated in twelve of twenty-eight patients.

3. Growth is more likely to be stimulated if the operation is done on children between the chronological ages of six and twelve.
CALCIFICATION IN ARTICULAR CARTILAGE
Authors: Hosking G. E. , Clennar G.
Published: February 2018

A case of calcification of articular cartilage in association with a parathyroid tumour is described. Previously reported cases of articular calcification are briefly discussed, and it is recommended that patients with articular calcification of undetermined cause should be investigated for hyperparathyroidism.
THE VASCULAR CONTRIBUTION TO OSTEOGENESIS
Authors: Trueta J. , Amato V. P.
Published: February 2018

In this work the role of the blood vessels surrounding the epiphysial growth plate has been studied. The nutritional dependence of the proliferative cells on the epiphysial vessels has been established whereas the metaphysial vessels were seen to take part in calcification and ossification at the metaphysis.

As it does not seem likely that the blood circulating in the two systems of vessels had a different constitution, particularly in hormones and vitamins, it seems permissible to assume that it is the characteristics, particularly in shape and number, of such vessels that make growth the orderly process it is, with the repeated birth of a cell at the top of a column and burial at the bottom end. But, despite this undeniable role of the vessels, growth depends on the ability of the cartilage cell to form a matrix which, in due course, will be avid for apatite crystals.
CONGENITAL DISLOCATION OF THE HIP
Authors: Wilkinson John , Carter Cedric
Published: February 2018

1. The histories of 149 patients, coming to the Hospital for Sick Children within the first three years of life with congenital dislocation of the hip (191 dislocated hips), and treated by conservative methods, have been reviewed.

2. The patients with unilateral dislocations (107) have been divided into three groups, according to the angle of slope of the opposite acetabulum. This angle was measured on the first radiograph and related to the mean value for age and sex.

3. The opposite hip was classed as "normal" if the acetabular angle was below or within one standard deviation above the mean for sex and age; as "moderately shallow" if it was between one and two standard deviations above the mean; and as "shallow" if it was over two standard deviations above the mean. This grouping was found to have a direct bearing on the results of conservative treatment in unilateral cases. a) Those with "normal" opposite acetabula–accounting for most of the unilateral cases–responded well. b) Those with "moderately shallow" opposite acetabula responded variably. c) The group with "shallow" opposite acetabula usually failed to respond.

4. Most bilateral dislocations behaved as unilateral dislocations with shallow opposite hips.

5. Additional factors influencing the response to conservative treatment–sex, age at first attendance, family history, fragmentation of the femoral epiphysis and eccentric reduction–are discussed.
A CONGENITAL MALIGNANT SYNOVIAL TUMOUR OF BONE
Authors: Evans R. Winston , Thomas G. E. , Walker Norah M.
Published: February 2018

A case of synovial sarcoma of the humerus is described. The histological features were of an undifferentiated character and the tumour arose in the foetus.
HETEROTOPIC OSSIFICATION IN PARAPLEGIA
Authors: Damanski M.
Published: February 2018

1. A clinical study has been made of heterotopic ossification in 273 patients with paraplegia of traumatic and non-traumatic origin treated at the Liverpool Paraplegic Centre over a period of twelve and a half years.

2. The literature is reviewed and theories of etiology are discussed.

3. Etiological factors have been studied. Prominent among these is inadequacy of early treatment leading to urinary infection and to the formation of pressure sores.

4. It is concluded that there is no effective treatment for established heterotopic ossification.

5. The importance of prophylactic treatment is stressed. Special emphasis is placed on adequate primary treatment, correction of hypoproteinaemia and early mobilisation.
INTRASPINAL EPIDERMOID TUMOURS IN THE LUMBAR REGION OF CHILDREN
Authors: Blockey N. J. , Schorstein J.
Published: February 2018

Six children who complained of pain and stiffness in the back had been treated with lumbar punctures between six and ten years before they came under observation. They were found to have intrathecal epidermoid tumours in the lumbar region which are presumed to have arisen from implanted skin fragments. The main evidence for this assumption is that since 1956 sixteen patients with lumbar epidermoid tumours in patients who had had previous lumbar punctures have been reported, in contrast to the five patients with lumbar epidermoid tumours recorded before that date. This suggests that there is an additional etiological factor.
RELAPSED CLUB FOOT
Authors: Evans Dillwyn
Published: February 2018

1. An operation which can correct congenital club foot deformity in older children is described.

2. The operation is based on the assumption that the essential element in a complex tarsal deformity is a displacement of the navicular bone on the talus and that all other elements of the deformity are secondary and adaptive.

3. The results of the operation are noted and the implications of some of its effects are discussed.
RUPTURE OF THE AXILLARY ARTERY
Authors: Gibson J. M. C.
Published: February 2018

1. Two cases of rupture of the axillary artery without dislocation of the shoulder or fracture of the neck of the humerus are reported, and the etiology is discussed.

2. The treatment of a ruptured axillary artery is primary repair, and not ligation.

3. In the repair of the artery the complete clearance of distal thrombus is most important; retrograde flushing is advised for this purpose.
OSTEOMYELITIS OF THE PATELLA
Authors: Evans David K.
Published: February 2018

1. Five new cases of pyogenic osteomyelitis of the patella are reported.

2. The clinical features are reviewed and the diagnostic pitfalls enumerated.
ANTERIOR LAXITY OF THE ANKLE
Authors: Flint Michael H. , MacKenzie Ian G.
Published: February 2018

1. Recurrence of deformity after operations for drop foot is often associated with opening of the front of the ankle joint: this has previously been regarded as a complication of the operation.

2. This study of sixty paralytic drop feet treated conservatively reveals that this laxity was in fact present in no less than 43 per cent.

3. The laxity is most commonly found when the calf muscle is strong and it can occur within a year of the onset of the paralysis. It is not always prevented by wearing a toe-raising spring.

4. Such anterior laxity may well be a common cause of failure of many of the standard operations for drop foot.

5. Before operation for drop foot is undertaken a lateral radiograph of the ankle should be taken in forced plantar-flexiori. If this demonstrates anterior laxity any standard operation is unlikely to succeed unless the anterior fibres of the collateral ligaments are protected from strain by simultaneous tendon transplantation or unless the ankle is included in the arthrodesis.
THE INCIDENCE OF OSTEOPOROSIS IN PATIENTS WITH FEMORAL NECK FRACTURE
Authors: Stevens Jack , Freeman P. A. , Nordin B. E. C. , Barnett Ellis
Published: February 2018

1. Recently described histological and radiographic methods of diagnosing osteoporosis have been applied to patients with transcervical and intertrochanteric fractures of the femur.

2. Both methods indicate a higher incidence of osteoporosis in such patients than in a control series, especially in older women with intertrochanteric fractures.

3. A discrepancy between the results of biopsy and radiographic examination was encountered, the explanation of which is not yet clear.
CORRECTION OF THE PRONATED FOOT
Authors: Rose G. K.
Published: February 2018

1. A simple model embracing both the hind and forefoot is described.

2. From this model the expected results of various methods of correcting the pronated foot can be deduced, and these were confirmed by human experiment.

3. It is indicated that a permanent correction requires a biological modification of foot posture achieved by mechanical means.
RHEUMATOID HAND DEFORMITIES CONSIDERED IN THE LIGHT OF TENDON IMBALANCE. I
Authors: Vaughan-Jackson O. J.
Published: February 2018

1. The posture of deformed finger joints in rheumatoid arthritis needs close analysis in terms of disturbed muscle balance. Although disorganisation of the joint itself may be the primary factor in the development of deformity, the deformity is often secondary to an extrinsic disturbance of muscle balance.

2. The part played by tendon ruptures in producing such imbalance is discussed.
THE SURGICAL TREATMENT OF HAEMOPHILIC BLOOD CYSTS
Authors: Hall M. R.P. , Handley D. A. , Webster C. U.
Published: February 2018

1. The treatment of two haemophilic patients with cystic haematoma by radical surgical excision is described.

2. Details are given of their management after operation with the successful use of animal and human antihaemophilic globulin to control bleeding.

3. The literature of cystic haematoma in haemophilia is briefly reviewed and the seriousness of this condition stressed.
ACUTE PEPTIC ULCERATION AND CEREBRAL FAT EMBOLISM AFTER FRACTURE
Authors: Teare R. D. , Bowen D. A.L. , Drury R. A.B.
Published: February 2018

1. Three cases of acute peptic ulceration are reported after cerebral fat embolism complicating skeletal injuries. In two instances death occurred after perforation of an ulcer, and in the third intestinal haemorrhage led to death.

2. Although intracranial lesions and peptic ulceration have been reported on many occasions, so far as we know cerebral fat embolism as a cause has not been previously recognised.

3. The possible pathogenesis is discussed.
OBSERVATIONS ON THE ETIOLOGY OF TIBIA VARA
Authors: Golding J. S. R. , McNeil-Smith J. D. G.
Published: February 2018

1. Twenty-eight cases of the infantile and three cases of the adolescent type of tibia vara occurring in West Indian Negroes are reported.

2. The condition is characterised by failure of growth of the postero-medial part of the upper tibial epiphysis.

3. The deformity produced is acute varus at the upper tibia with medial torsion and eventually flexion of the diaphysis on the epiphysis.

4. These deformities are considered to be due to a vicious circle set up by considerable alteration of the lines of force on the medial portion of the upper tibial epiphysial line.
A NEW METHOD OF RESTORING SENSIBILITY TO THE THUMB
Authors: Holevich J.
Published: February 2018

1 . A method of restoring protective sensibility to the thumb by a neurovascular pedicle graft is described.

2. The pedicle is taken from the dorsum of the index finger.

3. The method has been modified to include a racquet-shaped skin flap to give continuous sensibility from the pulp down the antero-medial border of the thumb.
PRIMARY POLLICISATION OF AN INJURED MIDDLE FINGER
Authors: Sallis J. G. , Elizabeth Port
Published: February 2018

1. Primary pollicisation of an injured middle finger is described.

2. The value of stellate ganglion block in preserving the blood supply is emphasised.
BILATERAL CONGENITAL APLASIA OF THE FEMUR
Authors: Mital M. A. , Masalawalla K. S. , Desai M. G.
Published: February 2018

1. An unusual case of bilateral and symmetrical congenital aplasia of the femur in a man of fifty is described.

2. The literature on the condition is reviewed and discussed.
FUNCTION OF THE SUPRASPINATUS MUSCLE AND ITS RELATION TO THE SUPRASPINATUS SYNDROME
Authors: van Linge B. , Mulder J. D.
Published: February 2018

1. In ten healthy young men an experimental paralysis of the supraspinatus muscle was induced with the aid of Xylocaine injected in or near the suprascapular nerve.

2. The completeness of the paralysis was checked by electromyography.

3. With the supraspinatus muscle completely eliminated, all subjects could move the arm against gravity through its full range in the shoulder joint, though the force and the power of endurance during abduction were diminished.

4. It is concluded that the role of the supraspinatus muscle is of a quantitative nature only.
THE MECHANICS OF THE HIND FOOT IN CLUB FOOT AS DEMONSTRATED RADIOGRAPHICALLY
Authors: Heywood A. W. B.
Published: February 2018

1. Lateral radiographs of fifty-seven club feet and seventeen normal feet were taken in forced flexion and forced extension. On these, the arcs traversed by the talus, the sole and the calcaneus were measured, as was the talo-calcaneal angle.

2. It was found that the ankle in club feet usually contributed more than half of the total sagittal movement of the foot.

3. Occasional cases were encountered in which the ankle was so damaged that it contributed only half or less than half of this movement. In such cases wedge excision of the ankle joint is theoretically justified in preference to wedge tarsectomy.

4. The talo-calcaneal angle is much reduced in club foot, and this element of deformity is extremely resistant to manipulative treatment. The reasons for this and a possible method of treatment are discussed.
THE EFFECT UPON THE INFERIOR RADIO-ULNAR JOINT OF EXCISION OF THE HEAD OF THE RADIUS IN ADULTS
Authors: Taylor T. K. F. , O'Connor B. T.
Published: February 2018

1. Fifty-eight adult patients who had been treated for radial head fractures by excision of the head of the radius have been reviewed at periods varying between two and nineteen years after operation.

2. Symptoms referable to the inferior radio-ulnar joint were present in half of the patients and the mechanisms of the disorder in these patients are discussed in the light of a radiographic study.

3. We feel it justifiable to conclude from our observations that this complication of surgical treatment of radial head fractures deserves greater attention than has been given to it in the past, and that it is of sufficient importance to be taken into consideration when planning the management of these fractures, especially the less severe injuries.

4. Prosthetic replacement of the proximal end of the radius is the logical and, indeed, the only way in which the distal radio-ulnar joint subluxation can be avoided, but no clearly defined indications for the routine use of a prosthesis as a primary procedure can be suggested on the basis of this investigation.
POST-TRAUMATIC EROSIONS OF ARTICULAR CARTILAGE
Authors: Crock H. V.
Published: February 2018

1. Sixteen patients with articular cartilage erosions after slight injury have been described, as have the results of their treatment.

2. The clinical features of this rarely diagnosed condition are discussed. Attention is drawn to "articular crepitus" and "synovial crepitus" as useful physical signs in establishing the diagnosis.

3. A radiographic sign of localised subarticular osteoporosis is reported and discussed.

4. The surgical treatment used was either shaving of the affected area of cartilage or a combination of shaving with drilling of the subchondral bone plate.
HEMIMELIC SKELETAL DYSPLASIA
Authors: Saxton H. M. , Wilkinson J. A.
Published: February 2018

1. A case is reported of a Jamaican boy of fifteen months with typical and florid manifestations of dysplasia epiphysialis hemimelica associated with a number of atypical features not previously recorded.

2. The progress of the disorder over a limited period of two years is described and the development of the atypical features is discussed.
TRIANGLE PINNING FOR FRACTURE OF THE FEMORAL NECK
Authors: Smyth E. H. J. , Ellis J. S. , Manifold M. C. , Dewey P. R.
Published: February 2018

1. A method of internal fixation of displaced subcapital fractures of the femoral neck is described, and a consecutive series of seventy-one patients whose fractures were treated by this method is reviewed.

2. It is claimed that this method gives better mechanical fixation than a trifin nail and that the operation is less formidable than the insertion of a pin and plate.

3. It is suggested that with improved fixation the avascular head can be supported while revascularisation occurs.
BLADDER PARALYSIS IN CAUDA EQUINA LESIONS FROM DISC PROLAPSE
Authors: Scott P. J.
Published: February 2018

1. Ten patients with neurological evidence of damage to the intrathecal sacral nerve roots of the cauda equina by verified lumbar disc prolapse are described.

2. The nature of the bladder paralysis has been investigated by cystometry and the findings contrasted with published opinions.

3. The prognosis of the bladder paralysis has been established by review up to six years after removal of the disc prolapse. No evidence of recovery of complete bladder paralysis has been found, but the consequences of persistent bladder paralysis have been much less severe than previous reports have stated. Reasons have been suggested for this.

4. Principles of recognition and management of bladder paralysis due to cauda equina lesions have been stated and methods suggested.
PREMATURE EPIPHYSIAL FUSION AT THE KNEE COMPLICATING PROLONGED IMMOBILISATION FOR CONGENITAL DISLOCATION OF THE HIP
Authors: Botting T. D. J. , Scrase W. H.
Published: February 2018

1. Three cases of premature epiphysial closure at the knee complicating prolonged immobilisation for congenital dislocation of the hip are described.

2. The etiology of this complication is briefly discussed, and it is suggested that relative ischaemia of the epiphysial plates is the most likely cause.
ON NECROSIS OF THE FEMORAL READ AFTER FRACTURE OF THE NECK OF THE FEMUR
Authors: Bohr H. , Larsen E. Hjalmar
Published: February 2018

1. The development of sclerosis of the femoral head after fracture of the femoral neck has been investigated by a combined microradiographic and histological examination of twenty femoral heads removed during arthroplasty of the hip done at varying intervals after fracture.

2. Mineralisation of the bone did not differ from the normal.

3. There was a direct correlation between the density of the femoral head as judged radiologically and the width of the trabeculae. In cases of sclerosis of the femoral head the trabeculae were broader than normal and histological examination showed that this was caused by apposition of new bone upon the necrotic trabeculae.

4. Although sclerosis is a result of necrosis, it is at the same time a definite sign that revascularisation and restitution are going on.
OSTEOARTICULAR CHANGES IN A CASE OF ESSENTIAL OSTEOLYSIS
Authors: Lagier R. , Rutishauser E.
Published: February 2018

1. A case of essential osteolysis is presented, occurring in a young man of eighteen with no known family history and developing progressively from early childhood. The condition was radiologically evident in the elbows, hands and feet, and was accompanied by atrophy of the cancellous bone of the epiphyses of the shoulders and knees. It was also associated with certain abnormalities of the skull and vertebrae. The patient died from a nephropathy of late onset.

2. Examination of the left foot revealed on the radiologically "lysed" bony extremities a very slow process of erosion affecting essentially the epiphysial and metaphysial cortical bone, of a non-inflammatory nature and accompanied by disappearance of the hyaline cartilage. The extremities not radiologically "lysed" showed signs of erosion that were histologically similar but not macroscopically evident; they were accompanied by regressive changes in the hyaline cartilage.

3. There were no signs of renal osteodystrophy or of Sudeck's dystrophy.

4. Post-mortem tests revealed an increase in the seromucoids and failed to reveal the presence of proline in the serum or of proline and hydroxyproline in the urine.

5. The authors discuss the place of this condition among osteolyses in general.
ABDUCTION CONTRACTURE OF THE SHOULDER FROM CONTRACTURE OF THE INTERMEDIATE PART OF THE DELTOID
Authors: Bhattacharyya S.
Published: February 2018

1. Three cases of abduction contracture of the shoulder caused by fibrosis of the intermediate part of the deltoid muscle are described.

2. Treatment by removal of the affected part of the muscle was successful in each case.

3. Histological findings are described and the nature of the condition is discussed.
DUPUYTREN'S CONTRACTURE: AN AUTO-IMMUNE DISEASE?
Authors: Burch P. R. J.
Published: February 2018

1. On the basis of, first, a mathematical analysis of the age-specific and sex-specific prevalence of Dupuytren's contracture; second, the genetical aspects; and last, the pathology, it is concluded that Dupuytren's contracture is probably a spontaneous disturbed-tolerance auto-immune disease.

2. The proportion of predisposed individuals at birth is about 20 per cent of males and females in the population studied by Early (1962), although it differs between populations and races.

3. The disease is probably initiated by four random, dependent-type, autosomal somatic gene mutations in a stem cell of the lymphoid system. With the accumulation of the fourth and final somatic mutation, a "forbidden-clone" of lymphocytes is probably generated. There is a latent period between the occurrence of the last initiating event and diagnosis.

4. In men the average latent period is about fifteen years, in women it is about thirty years.

5. The target tissue primarily attacked by forbidden lymphocytes is unknown, although proliferating fibroblasts are evidently a consequence of the auto-immune attack.
CORRECTION OF LEG LENGTH DISCREPANCY BY EPLPHYSIAL ARREST
Authors: Menelaus M. B.
Published: February 2018

1. A simple calculation for the timing of epiphysial arrest to correct leg length discrepancy is described. An assumption is made that growth ceases at a constant chronological age of sixteen years in boys and fourteen years in girls. It is further assumed that the lower femoral epiphysis provides three-eighths of an inch and the upper tibial epiphysis one-quarter inch of growth each year.

2. Whilst the assumptions made are known to be approximations, analysis of the results of fifty-three epiphysial arrests in forty-four children shows that the errors cancel themselves sufficiently to make this method accurate. The simplicity of the calculation makes it useful to confirm or modify the timing of arrests calculated on the basis of skeletal age, or as an alternative method.
PITFALLS IN THE MANAGEMENT OF CONGENITAL DISLOCATION OF THE HIP
Authors: Lloyd-Roberts G. C. , Swann Malcolm
Published: February 2018

The management of a personal series of over 500 patients with congenital hip dislocations has been reviewed with special reference to the mistakes that have been made and the safeguards which have now been adopted.
TRANSPOSITION OF LATISSIMUS DORSI FOR PARALYSIS OF TRICEPS BRACHII
Authors: du Toit G. T. , Levy S. J.
Published: February 2018

1 . A case is described in which complete transposition of the latissimus dorsi muscle with its neurovascular pedicle was performed to compensate for complete paralysis of the triceps and partial paralysis of the posterior part of the deltoid muscle.

2. Muscle necrosis did not occur to any significant degree.

3. Strong substitute triceps function was achieved.
SOME OBSERVATIONS ON THE EFFECTS OF BLOOD AND A FIBRINOLYTIC ENZYME ON ARTICULAR CARTILAGE IN THE RABBIT
Authors: Guicciardi E. , Little K.
Published: February 2018

1. In rabbit knees the effects of daily injections of saline, Varidase, blood, blood and Varidase simultaneously, and blood alternating with Varidase every third day have been compared.

2. Saline alone produces changes in joint cartilage comparable with a slight damage to the gel structure of the intercellular matrix.

3. The other four experiments resulted in changes in the articular cartilage comparable with the effects of a partial chemical degradation of the polysaccharide of the intercellular matrix.

4. Blood also induced hypertrophy of the synovial tissues. After the end of the injections healing of the cartilage was slower than with saline or with Varidase.

5. When blood and Varidase were given together the immediate effects were additive, but there was a considerable delay in healing.
NON-UNION AFTER INTERTROCHANTERIC OSTEOTOMY WITH INTERNAL FIXATION FOR OSTEOARTHRITIS OF THE HIP
Authors: Rosborough D. , Stiles P. J.
Published: February 2018

1. One hundred and eight osteotomies were reviewed with regard to union, and fourteen were found to be ununited. In only one was non-union detected clinically; the others required radiographic demonstration. Tomographs were particularly helpful in confirming non-union.

2. Nine patients with non-union had pain, equal to or worse than before operation. The pain could not be distinguished from that of osteoarthritis of the hip.

3. Six of the patients with non-union needed an operation. Five had cancellous bone grafts followed by union in all except one.

4. The causes of non-union are reviewed. This complication was found to be less frequent in patients above sixty with stiff hips and bony collapse on the radiograph. Horizontal osteotomy with a displacement of not more than one-third of the diameter of the shaft reduced the incidence of non-union. The variable-angle nail-plate provided the best fixation. Traction provided no benefit and increased the incidence of non-union. Weight bearing is best avoided for eight weeks.
POTT'S PARAPLEGIA
Authors: Guirguis Anwar R.
Published: February 2018

1. A comparison of the results of sixty patients with Pott's paraplegia, half operated upon and half treated conservatively, showed that better results were achieved in a much shorter time in those treated surgically.

2. Extra-pleural antero-lateral decompression is the operation of choice in cases of Pott's paraplegia.

3. The operation should be done as soon as the general condition of the patient allows, and should not be left until the disease is quiescent.

4. The greatest improvement is found in those patients who are still ambulant.

5. Although the gain in patients with complete paraplegia may be small, relief from painful flexor spasms and the healing of bed-sores often justify surgical treatment.

6. Fusion of the vertebral bodies can be carried out at the same sitting using healthy ribs and sometimes cancellous bone, with satisfactory results.
TUMORAL CALCINOSIS
Authors: Smit Graham G. , Schmaman A.
Published: February 2018

1. Tumoral calcinosis and lipocalcinoma-granulomatosis are synonymous terms for the same entity.

2. The condition justifies inclusion as an important type of calcinosis and is to be differentiated from calcinosis universalis and calcinosis circumscripta.

3. It occurs during the first or second decades, large dense nodular masses forming in the periarticular tissues at the hips, shoulders and elbows. Smaller masses may have a wider distribution.

4. It has been reported to be a metabolic disease of obscure etiology.

5. The course is benign but excision of the masses should be undertaken early to avoid operative difficulties and secondary infection.
HAND INJURIES CAUSED BY INJECTION OF CEMENT UNDER PRESSURE
Authors: Hutchinson C. H.
Published: February 2018

1. Three cases of cement injection into the tissues of the thumb and index finger are recorded.

2. This is probably the first description of this type of injection injury.

3. Recommendations are made for the prevention of the injury.
DELAYED ARTERIAL OCCLUSION IN LIMB INJURIES
Authors: Porter M. F.
Published: February 2018

1. Three cases of delayed occlusion of the popliteal artery following trauma are described.

2. The lesion responsible is a partial rupture of the vessel with subsequent thrombosis.

3. All such lesions should be explored and preferably resected.
ARTHRODESIS OF THE HIP
Authors: Lam S. J. S.
Published: February 2018

1. Sixty-nine patients with degenerative disease of the hip joint were treated by intra-articular arthrodesis using secure internal fixation. External fixation with plaster was not used and the patients were mobilised on crutches after a mean interval of 3·2 weeks. Radiologically evident bony union occurred in 87 per cent of cases. Among the nine patients (13 per cent) who failed to show union only three complained of persistence of severe symptoms.

2. The only significant complication was fracture of the upper femoral shaft in three cases (4·3 per cent). However, this has not occurred since a small plate was used in addition to the nail.

3. The disadvantages of the routine use of plaster fixation are discussed and are contrasted with the advantages of early mobilisation without plaster.

4. Whereas this series does not show a rate of fusion as good as that in the best reported series, it supports the view that arthrodesis of the hip offers the most certain, reliable and efficient means of treatment for severe unilateral degenerative disease of that joint.
CARTILAGE OR BONE INDUCTION BY ARTICULAR CARTILAGE
Authors: Urist Marshall R. , Adams Thompson
Published: February 2018

1. Isografts of articular cartilage of young rats, with mucoproteins labelled with 35S, extracellular fibrous proteins labelled with 3H-glycine, and nuclei labelled with 3H-thymidine, were transplanted into the anterior chamber of the eye.

2. Thin split-thickness transplants of the cells of the gliding surface of immature articular cartilage induced the formation of fibrous tissue.

3. Thick transplants and subsurface slices of immature articular cartilage, containing germinal cells of the epiphysial cartilage, induced the formation of new bone consistently within 4 weeks.

4. Full-thickness transplants in articular cartilage from senile rats induced only the formation of fibrous tissue.

5. Slices of growing cartilage, devitalised by cryolysis, or extraction of acid-soluble proteins, produced scanty deposits of bone or cartilage, or both, but only infrequently and generally after a lag phase extending from six to twelve weeks.

6. Reduction in the amount of mucoprotein in the cartilage matrix by papain, and suppression of the resynthesis of tissue proteins by cortisone, retarded but did not prevent bone induction.

7. Bone induction is the product of a series of interactions between inducing cells and responding cells by intracellular and intercellular reactions too complex to characterise in physico-chemical terms at this time.
MASSIVE HAEMORRHAGE FOLLOWING PELVIC FRACTURE
Authors: Lawson L. J. , Wainwright D.
Published: February 2018

1. A case of fractured pelvis with massive haemorrhage from the right superior gluteal artery and thrombosis of the right ilio-femoral venous system is reported.

2. The treatment included ligature of the artery and extensive thrombectomy. Ten litres of blood were transfused.
ISCHAEMIA COMPLICATING INJURY
Authors: McQuillan W. M. , Nolan B.
Published: February 2018

1. The types of ischaemia that accompany injuries to a limb are described.

2. The ischaemia may be total or local.

3. Thirty-seven cases of total or local ischaemia of a limb are analysed and conclusions are drawn therefrom.
CONGENITAL DISLOCATION OF THE HIP IN THE NEWBORN
Authors: Smaill G. B.
Published: February 2018

1. Six thousand consecutive newborn babies were personally examined by the author for congenital dislocation of the hip. Twenty-four cases were diagnosed and twenty-three treated.

2. Twenty-two of the twenty-three treated cases had excellent results after treatment in the von Rosen splint.

3. The baby should be five days old before a final decision is made as to whether treatment is necessary.

4. A further twenty-seven babies were found to have unstable hips. Eighteen of these were followed up and all were found to have developed normally without treatment.

5. The technique of examination is simple and quick but it is desirable that it should be carried out in each maternity unit by only one or two doctors.
CONGENITAL DISLOCATION OF THE HIP
Authors: Hiertonn T. , James U.
Published: February 2018

1. Out of 11,868 children born in one maternity department and examined neonatally three cases (possibly four) of typical dislocation were missed at the first examination but diagnosed and treated with good results within the following few months.

2. One single neonatal examination of the hip is not sufficient. Repeated examinations during the first weeks and months are essential.

3. Treatment with a Frejka pillow is unsatisfactory. The von Rosen splint is preferable.

4. Following the campaign for neonatal diagnosis and early treatment no case of established dislocation has been encountered after the age of six months.

5. Atypical cases present special problems.
A METHOD OF FLEXOR TENDON SUTURE
Authors: Shaw P. C.
Published: February 2018

1. A new method of tendon suture using a barbed wire is described.

2. Experimental evidence suggests that it may prove superior to existing methods.
FRACTURE-DISLOCATION OF THE LUMBO-SACRAL SPINE WITH CAUDA EQUINA LESION
Authors: Dewey P. , Browne P. S. H.
Published: February 2018

1. Two cases of fracture-dislocation of the spine at the lumbo-sacral level are reported.

2. One patient was treated conservatively and survived, with a cauda equina lesion which is now recovering. One patient was treated by operative decompression and died offat embolism.

3. The lumbo-sacral joint is locked in the dislocated position.
THE MANAGEMENT OF GAS GANGRENE WITH HYPERBARIC OXYGEN THERAPY
Authors: Colwill M. R. , Maudsley R. H.
Published: February 2018

1. The management of gas gangrene by hyperbaric oxygen is described.

2. The mode of action, administration and risks of hyperbaric oxygen are discussed.

3. A series of seventeen cases, with one death, is recorded from a hospital unit with a small chamber, using two atmospheres in pure oxygen.
SURGICAL TREATMENT OF FRACTURES THROUGH METASTASES IN THE PROXIMAL FEMUR
Authors: Poigenfurst Johannes , Marcove Ralph C. , Miller Theodore R.
Published: February 2018

The results of 110 operations for the treatment of fractures through metastases in the femoral neck and intertrochanteric region have been studied. Of these, forty-four fractures were treated by internal fixation, forty-six by resection of the femoral head and neck, and twenty by prosthetic replacement. The following conclusions were reached.

1. Prosthetic replacement of the femoral head is a reliable procedure.

2. The long stem type of prosthesis has the advantages of greater stability and simultaneous fixation of the shaft.

3. Patients with diffuse metastatic disease of the ilium are not suitable for prosthetic replacement. These patients should be treated by resection of the femoral head and neck.

4. Resection is a less traumatic procedure and therefore useful in the palliative treatment of patients in poor general condition.

5. Internal fixation leads more often to complications and unfavourable results than do the other methods.