bluuebunny/crossref_metadata_2025_split huggingface dataset:
DISPLACEMENT OSTEOTOMY IN THE TREATMENT OF OSTEOARTHRITIS OF THE HIP
Authors: Nicoll E. A. , Holden N. T. 
Published: February 2018

1. Almost all patients with osteoarthritis of the hip who consult the surgeon do so because they wish to be relieved of pain. They all have limitation of movement in varying degrees but most of them will be either unaware of it or will have accepted it. What is more important, they would not have sought medical advice because of stiffness if there had been no pain. The primary objective of operative treatment must therefore be to relieve pain. 2. Displacement osteotomy will give substantial relief from pain in a high proportion of cases and the relief is lasting. Perhaps that explains why this operation, advocated by McMurray and Malkin twenty-five years ago, is being practised more widely than ever to-day while its competitors (neurectomy, capsulectomy, arthroplasty) have steadily diminished in popularity. 3. The disadvantages of the operation are all related to post-operative immobilisation in plaster, which may induce further stiffness of the hip, even to the extent of ankylosis, or stiffness and pain in the knee. These disadvantages may be overcome to a considerable degree by internal fixation followed by sling suspension and early active movement. But when, under anaesthesia, the range of hip flexion is reduced to 45 degrees or less, the operation is always liable to result in ankylosis, and it is wise in these circumstances to take this possibility into account and warn the patient beforehand.
TORULOSIS
Authors: Allcock E. A. 
Published: February 2018

1. The natural history of cryptococcal infection is discussed in relation to the findings in a woman of fifty-six with lesions in the right radius and right fourth metatarsal. A diffuse lesion found in the right lung with a calcified gland at the right hilum was believed to represent the initial site of infection. 2. There was a general tendency for normal bone architecture to be restored after the destructive phase of the disease had finished. 3. Specific treatment with the fungicide amphotericin B had to be stopped because of severe systemic reaction. 4. The significance of the rare association of Boeck's sarcoid with torulosis is discussed.
CERVICAL KYPHOSIS FROM POSTERIOR HEMIVERTEBRAE WITH BRACHYPHALANGY AND CONGENITAL OPTIC ATROPHY
Authors: Berk M. E. , Tabatznik B. 
Published: February 2018

1. An unusual congenital anomaly of the cervical spine is described. This lesion caused a localised cervical kyphosis and resulted in the development of a mild tetraparesis. 2. The case reported is believed to be the first on record in the English literature of multiple posterior hemivertebrae in the cervical region. 3. The neck deformity was associated with an unusual combination of developmental anomalies–namely, brachyphalangy and bilateral congenital optic atrophy. 4. The importance of differentiating between congenital and acquired causes of kyphosis is emphasised. 5. The radiographic appearances of posterior hemivertebra are described, and the differential diagnosis is considered. 6. The development of the vertebral body, and the relationship between coronal cleft vertebra and posterior hemivertebra, are discussed. The possible role of a disturbance of vascular supply in pathogenesis is mentioned. 7. This report augments the growing literature on congenital skeletal anomalies occurring in combination with isolated congenital ocular defects.
EXCISION OF THE LUNATE BONE IN KIENBÖCK'S DISEASE
Authors: Gillespie H. S. 
Published: February 2018

1. Twenty-four cases of excision of the lunate bone in Kienböck's disease have been reviewed. 2. In general, the results have been favourable, with 88 per cent excellent or good and 12 per cent fair or poor. 3. Abnormal contact between the triquetrum and the styloid process of the ulna appeared in many cases, but this contact did not appear to prejudice the results. 4. Excision after prolonged symptoms of the disease gave disappointing results.
ENGELMANN'S DISEASE
Authors: Lennon Evan A. , Schechter Mannie M. , Hornabrook Richard W. 
Published: February 2018

Engelmann's disease appears to be a familial and probably hereditary systemic condition, in which most of the manifestations can be attributed to a disorder in the osseous and muscular systems. At present the nature of the pathological process is obscure. The manifestations may present soon after birth or become apparent later in life. There is evidence that it is progressive but it may become arrested in some patients. In order that this very incomplete state of knowledge may be improved it will be necessary to observe patients and their relatives throughout their lifetime.
BRACHIAL PLEXUS INJURIES: TREATMENT OF THE FLAIL ARM
Authors: Yeoman P. M. , Seddon H. J. 
Published: February 2018

1 . Thirty-six patients with complete irrecoverable brachial plexus lesions have been studied. 2. Function has been compared after 1) arthrodesis of the shoulder with amputation through the arm, 2) so-called reconstructive procedures, and 3) no operative treatment. 3. The results of reconstructive operations have been so disappointing that we believe that this type of treatment should be abandoned. 4. Amputation-arthrodesis offers a better functional result than either reconstruction or no operation. Its value depends to a considerable extent on the manual dexterity of the patient. 5. A clerical worker who is not mechanically minded is less likely to use an artificial limb, and in this type of patient operation is perhaps best avoided.
RECURRENT DISLOCATION OF THE PATELLA
Authors: Heywood A. W. B. 
Published: February 2018

1. A study has been made of the treatment of recurrent dislocation of the patella in 106 knees in seventy-six patients. 2. In young adults in whom degenerative changes in the knee were not severe at the time of operation transplant of the tibial tubercle gave the best results. 3. In older patients and in those in whom osteoarthritic changes were present in the knee transplant of the tibial tubercle was unsatisfactory, but patellectomy with rerouting of the quadriceps mechanism gave fair results. 4. Tibial tubercle transplant is contra-indicated in children because it may give a recurvatum deformity. 5. When the dislocation is permanent, operation may be unnecessary, but if it becomes inevitable simple patellectomy is the best procedure. 6. The results of plastic operations on the quadriceps expansion and of supracondylar femoral osteotomy are bad. 7. No operation can give consistently good results because the knee is usually congenitally weak, often as part of generalised ligamentous laxity.
SUBCHONDRAL BONE CYSTS
Authors: Woods C. G. 
Published: February 2018

1. The clinical, radiological and pathological features in seven cases of subchondral bone cyst are described. 2. Various hypotheses on the etiology of the lesion are discussed. 3. Although the hypothesis of vascular disturbance is thought to be the most attractive one, it is concluded that study of material from much earlier lesions than that hitherto available is essential if any justifiable theory is to be propounded.
STUDIES IN THE TRANSPLANTATION OF BONE
Authors: Burwell R. Geoffrey , Gowland G. 
Published: February 2018

1. The effects of the insertion of pieces of fresh cancellous bone into the subcutaneous tissues of the ear upon lymph nodes and spleens have been investigated in seventy rabbits. 2. The main immunological response is found to occur in the first regional nodes draining the sites of insertion of homografts of bone, which show a considerable increase in weight compared with nodes draining autografts of bone. 3. An increased number of large and medium lymphoid cells occurs principally in the first regional node of the homografted animals, as Scothorne and McGregor (1955) observed using skin as the homografted tissue. 4. The large and medium lymphoid cell response is found in both the cortex and the medulla of the lymph nodes. In the cortex a sectoral distribution of the cellular response is observed and the name reactive cortex is given to these sectors. Evidence is presented to show that the sectoral pattern of reactivity is probably determined by the localised entry into the node of iso-antigens through lymphatic vessels draining the bed of the graft. 5. We have made a quantitative analysis of the large and medium lymphoid cell response in the reactive parts of the diffuse lymphoid tissue of the cortex. The mean maximal large and medium lymphoid cell response occurs five days after the insertion of bone homografts. 6. The origin and fate of the large and medium lymphoid cells and their role in the production of antibodies is reviewed in the light of recent work. 7. A correlation is made between the maximal production of large and medium lymphoid cells in the first regional lymph node, the invasion of the graft bed with small lymphocytes and the inhibition of new bone formation in the homografts.
MINOR REACTIONS DUE TO MODERN METAL
Authors: Hicks J. H. , Cater W. H. 
Published: February 2018

1. Two of the three metals at present in use in orthopaedic surgery have been studied to assess their tendency to cause wound reactions. 2. Cobalt-chrome alloy proved to be the better, the incidence of obligatory plate removal being at most 3 per cent. Visible corrosion in this metal never occurred. 3. 18/8 Mo stainless steel proved to be the poorer, the incidence of obligatory plate removal being 20 per cent. Visible corrosion of the metal is estimated to have occurred in about 5 per cent of screws inserted. 4. Regardless of such accelerating factors as metallic transfer, 18/8 Mo steel may have to be accepted as inherently more susceptible to corrosion than is cobalt-chrome alloy. 5. The qualities of two other stainless steels also became evident. Previous work describing the very bad situation arising from the use of EMS was confirmed. By contrast, a steel that was in use before 1951 gave little trouble. This steel was probably FSL.
THE GROWTH OF TRANSPLANTED FOETAL BONES IN DIFFERENT IMMUNOLOGICAL ENVIRONMENTS
Authors: Chalmers J. , Ray R. D. 
Published: February 2018

1. Homografts of eighteen-day-old foetal femora in pure strains of mice showed no fundamental difference in behaviour from grafts of more mature bone and cartilage. 2. Growth of bone was limited to a short period after transplantation and was abolished by previous immunisation. Cartilage growth alone was responsible for the increase in size of these transplants and did not appear to be influenced by the presence of immunity. 3. There is no reason to suppose that bone from an immature source is likely to behave more favourably than more mature bone homografts in clinical use. 4. The limited growth of cartilage and the total failure of bone survival in the heterografts indicate an immune reaction ofa different order from that which develops against the homograft. 5. The different effect of the homograft immune reaction on cartilage and bone enabled certain conclusions to be drawn concerning the part played by these two tissues in determining the form of a bone. Cartilage growth and development is shown to be regulated in large part by intrinsic factors. Bone growth and form on the other hand is shown to be dependent largely upon extrinsic influences.
MALIGNANT ANGIOBLASTOMA OF LONG BONE
Authors: Elliott G. B. 
Published: February 2018

Two cases of malignant angioblastoma of tibia are described, one finally treated by amputation and the other by segmental resection and grafting. They have remained free from signs of local recurrence or distant metastasis for five and a half and ten and a half years respectively. Both showed prominent areas of neoplastic mesenchymal angioblastic tissue which closely imitates solitary fibrous dysplasia. The natural history and radiological characteristics of these little-known tumours, long thought to be "adamantinoma" of bone, are described.
NEW APPROACHES TO THE PROBLEM OF OSTEOPOROSIS
Authors: Urist Marshall R. , Zaccalini Patrick S. , MacDonald Norman S. , Skoog William A. 
Published: February 2018

1. Individuals who are normal and not osteoporotic seem to show retention of cortical bone at successive decades of life in proportion to the total lean body-mass. In patients with osteoporosis the weight of the skeleton decreases at a rate exceeding the physiological rate of atrophy of muscle, tendon and bone tissue that occurs with the time-dependent process of ageing. 2. Six patients representing the typical forms of osteoporosis commonly found in orthopaedic practice were investigated intensively over a period of three years and compared with individuals in whom there was no osteoporosis by studies of metabolic balance, Sr85 osteograms, and tetracycline deposition. 3. Studies of metabolic balance in patients with osteoporosis showed normal or negative calcium balances, but an equilibrium for the metabolism of nitrogen and phosphorus. Increased intake of calcium in the diet produced retention of calcium but not sufficient phosphorus, nitrogen or gain in weight to prove that the patient had made new bone and healed the osteoporosis. 4. Radio-isotope osteograms showed high, normal or low rates of change of uptake of Sr85 and the accretion rate was calculated to be normal or low in individuals with osteoporosis. High uptake of tetracycline by a small mass of bone tissue and by a relatively small percentage of the total number of osteons suggested that in an adult human being the calcium reserve in the skeleton is enormous. Thirty to 50 per cent of the total bone mass was sufficient to turn over 0·5 to 1·0 gramme, the amount of calcium utilised in twenty-four hours by the human adult. This was accomplished by structural or old bone throughout the entire skeleton, and by labile or newer bone located in approximately 10 per cent of the total number of Haversian cylinders or osteons. 5. Some of the unclosed or half-closed osteons were hyperactive in osteoporotic bones. In the process of remodelling of cortical bone a significant quantity of bone tissue was incompletely restored and there were, presumably as a result, intermittently large or small negative calcium balances. Osteoporosis may have been the cause, rather than the result, of the negative calcium balance. 6. The experimental and clinical literature of the past ten years, and studies on patients described in this critical review, were interpreted to indicate that prolonged calcium deficiency, castration, hyperadrenal corticoidism or a sedentary life may precipitate, accentuate and accelerate osteoporosis in individuals who are genetically predisposed to develop it. Sometimes high calcium intake or sex hormones, or both, may have slowed the rate of resorption but did not replace the deficit in cortical bone. 7. Further research is necessary to find the chief etiological factor and to produce the cure for this increasingly common disorder of the skeleton.
OSTEOCHONDRITIS DISSECANS FOLLOWING LEGG-CALVÉ-PERTHES' DISEASE
Authors: Morris Martin L. , McGibbon Kenneth C. 
Published: February 2018

A case of osteochondritis dissecans complicating Legg-Calvé-Perthes' disease is reported. Despite four years of conservative treatment in an ischial-bearing caliper a part of the fragmented femoral head failed to unite with the rest of the epiphysis and has persisted as an intra-articular loose body. Freehafer (1960) listed the indications for surgical removal of this fragment in such cases: 1) persisting symptoms; 2) dislocation of the loose fragment into the joint with secondary arthritic changes inevitable; 3) a mechanical block to movement of the hip. Since our patient had a relatively symptomless hip with a full range of movement, surgical removal of the loose body was not advised. The prognosis for this hip is nevertheless guarded, and surgery can be reserved for the above indications or for reconstructive procedures should they be required in the future.
OBSERVATIONS OF THE INFLUENCE OF CHONDROITIN SULPHATE ON THE RATE OF BONE REPAIR
Authors: Burger Martin , Sherman Burton S. , Sobel Albert E. 
Published: February 2018

1. A study has been made of the repair of bony defects in the calvaria of albino rats. 2. An accelerated rate of bone repair was observed in experimental defects into which chondroitin sulphate-treated demineralised bone was implanted. 3. Acid-soluble collagen reconstituted with chondroitin sulphate was also more effective as an implant than was acid-soluble collagen reconstituted with sodium chloride. 4. It is concluded from these studies that chondroitin sulphate treatment accelerated the rate of new bone formation induced by demineralised bone, by reconstituted acid-soluble collagen, and to a lesser extent by Gelfoam. It was also found that demineralised bone and fresh homogenous bone promoted bone repair, but that chondroitin sulphate-treated demineralised bone promoted the most rapid rate of bone repair among the substances tested. 5. The possible role of chondroitin sulphate in bone formation is discussed.
THE RESPONSE OF MUSCLE TO STRENUOUS EXERCISE
Authors: Van Linge B. 
Published: February 2018

1. The effects of heavy training on a skeletal muscle have been studied in the rat. After denervation of the triceps surae muscle the tendon of the plantaris muscle was implanted into the tuberosity of the calcaneum. It was then possible to demand an unusual performance of the plantaris, the weight of which is only 18 per cent of the weight of the triceps surae. 2. Formation of new muscle fibres was observed after prolonged heavy training. This is incontrast to the opinion of most investigators, who have seen no new fibres formed after training. Degenerative changes followed by regeneration were also seen. 3. The trained muscle could almost double its weight, and treble its force. Paradoxically, the supposedly non-contractile sarcoplasm was seen to have increased after training. 4. Training induced a strong protein synthesis in muscle. In normal muscle protein synthesis can hardly be demonstrated. 5. Connective tissue grew between single muscle fibres in the heavily trained muscle. Its distribution was unequal. 6. Heavy exercise caused marked swelling of an untrained muscle. 7. Functional recovery was satisfactory after the operation. This showed that a muscle can be replaced by one only one-fifth its weight, provided the latter is trained adequately. 8. Not even the most arduous training could inflict permanent damage on the muscle.
A PRELIMINARY REPORT OF VASCULAR ASSAY IN PROGNOSIS OF THE FRACTURED FEMORAL NECK
Authors: Harrison M. H.M. 
Published: February 2018

1. A method is described for determining the presence or absence of a circulation within the femoral head after fracture of the neck of the femur. 2. An account is given of the fate of nineteen femoral heads in patients who had sustained high femoral neck fracture and in whom these tests had been carried out. 3. A favourable prognosis as regards fracture union and viability of the head was found to be correct in twelve of fifteen patients. 4. Non-union and major collapse of the head occurred in four patients in whom a diagnosis of an anaemic head had been made. 5. The morbidity of the method is described. 6. An explanation is given why vascular assay has been carried out as a secondary procedure, and possible clinical applications are indicated.
CERVICAL VERTEBRAL DEFORMITY IN VON RECKLINGHAUSEN'S DISEASE OF THE NERVOUS SYSTEM
Authors: Heard G. E. , Holt J. F. , Naylor B. 
Published: February 2018

1 . The bone changes in von Recklinghausen's disease of the nervous system are reviewed and the gross deformities that are sometimes encountered in the cervical region are illustrated. 2. A case is described in which, at necropsy, histological study of affected vertebrae revealed actual neurofibromatous erosion and infiltration.
INTRA-ARTICULAR AND PERI-ARTICULAR FRACTURES OF THE PHALANGES
Authors: Lee M. L. H. 
Published: February 2018

1. A review of intra-articular and peri-articular fractures of the phalanges has been carried out, and the late results of such injuries have been examined. 2. These fractures usually unite by bone. 3. The results of conservative treatment by immobilisation are satisfactory in the case of mallet fractures, hyperextension sprain fractures and collateral avulsion fractures of the proximal phalanges. 4. The less satisfactory results after collateral avulsion fractures of the interphalangeal joints and avulsion fractures complicating dislocations are discussed.
AVASCULAR NECROSIS OF THE LUNATE BONE TREATED BY EXCISION AND PROSTHETIC REPLACEMENT
Authors: Agerholm J. C. , Goodfellow J. W. 
Published: February 2018

Of fifteen patients treated by excision of the lunate bone and prosthetic replacement twelve had no pain at all or slight discomfort after exceptionally heavy work. All these were able to return to and continue at heavy manual jobs. Two patients continued to experience pain with vigorous use of the wrist but were none the less satisfied with their improvement. In one patient the operation failed and pain persisted unrelieved. We believe that the radiographs show that the prosthesis greatly minimises the distortion of the carpus after excision of the lunate bone and that the maintenance of a normal carpal architecture is important in the avoidance of osteoarthritis of the remaining joints. The results suggest that when the operation is technically successful degenerative changes do not occur despite prolonged and heavy use. The presence of osteoarthritis in the wrist before operation is not a contra-indication to prosthetic replacement because the degenerative process may remain stationary for several years after removal of the damaged lunate bone. The prosthesis has proved durable over many years and none of our patients having attained a good wrist has suffered a relapse. The operation entails a month off work for a heavy labourer and as little as a fortnight for those who do lighter jobs. These considerations prompt us to suggest its wider use in the treatment of Kienböck's disease.