bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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.
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.
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.
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.
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.
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.
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.
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.