bluuebunny/crossref_metadata_2025_split huggingface dataset:
A HISTOLOGICAL STUDY OF AVASCULAR NECROSIS OF THE FEMORAL HEAD AFTER TRANSCERVICAL FRACTURE
Authors: Catto Mary 
Published: February 2018

1. Loss of osteocytes in the bone trabeculae of the femoral heads of "normal" elderly patients was patchy and distinguishable from that resulting from avascular necrosis after fracture. 2. Changes in the haemopoietic marrow were the earliest and most sensitive indicators of ischaemia, loss of osteocytes rarely being complete until three or four weeks after fracture. 3. In 109 femoral heads removed more than sixteen days after fracture the viability could be determined by histological means. All of these had suffered some damage to the vascular supply but in a number the head remained alive apart from the region of the fracture line. These heads were nourished by the blood vessels of the ligamentum teres and sometimes by retinacular arteries, usually of the inferior group. 4. Some femoral heads became completely necrotic following fracture, others were only partly affected. A variable amount of the subfoveal region commonly remained alive and it was from this site that revascularisation spread into the head. The upper segment of the femoral head least often remained alive and its subchondral region was usually the last to revascularise. 5. In a group of unselected femoral heads a third remained alive following fracture and two-thirds were partly or completely necrotic. 6. Femoral heads which were partly necrotic appeared capable of uniting and completely revascularising, there being invasion of the necrotic bone by vessels from across the fracture line and from the ligamentum teres. This contrasted with the completely necrotic femoral heads described elsewhere in this issue which united but in the absence of proliferation of ligamenturn teres vessels failed to revascularise completely and developed late segmental collapse. 7. Avascular necrosis did not appear to be the sole cause of non-union. 8. Necrotic bone showed no alteration in radiological density. Reossifying bone in areas of revascularisation sometimes caused an absolute increase of radiodensity especially when associated with halted revascularisation. This increase of radiological opacity was the result of deposition of new on dead bone with broadening of the trabeculae. Marrow calcification was minimal. 9. Obliterative sclerosis of venules in the ligamentum teres was found in "normal" patients even in infancy. No thrombosis was seen in the ligaments following fracture but where the femoral heads were completely necrotic and not revascularised the ligaments were often also necrotic. 10. There appeared to be no increase in degenerative changes in the articular cartilage of the femoral heads following fracture compared with fifty elderly controls. Some loss of chondrocytes in the deep zone of the weight-bearing area was found in about a quarter of the femoral heads. In only one head was the cartilage almost completely acellular. An almost normal depth and a smooth contour of the articular cartilage were retained.
TRAUMATIC ISCHAEMIA OF THE CALF
Authors: Monk C. J. E. 
Published: February 2018

1. A patient with complete ischaemia of the muscles of the calf and anterior compartment of the leg is described. 2. In diagnosis, tenseness of the calf, equinus and pain on attempted dorsiflexion of the ankle are most important. 3. Peripheral pulses may be present and do not contra-indicate decompression by operation to prevent ischaemia.
OSTEOCHONDRITIS DISSECANS AND COXA PLANA
Authors: Stillman B. C. 
Published: February 2018

Both osteochondritis dissecans and coxa plana are diseases with identical pathological changes, namely avascular necrosis. Although the etiology is not known in either case, it seems likely that when the etiological factors are fully determined they will prove to be applicable to either condition. The relative importance of each etiological factor in the multiple pathogenesis of these two conditions is almost certainly different in each disease process, and probably in each individual case. Present day concepts suggest that there is an underlying constitutional disturbance, which is associated with other factors (of which trauma is almost universally accepted as being one; perhaps the only one), to predispose the individual to these conditions. It is hoped that further studies along these lines will not only help to provide a better understanding of the two conditions mentioned above, but will also be of value in the appreciation of the pathogenesis and etiology of a large number of disturbances including such varied conditions as dysplasia epiphysialis multiplex congenita, cretinoid dysgenesis of the capital femoral epiphysis, adolescent coxa vara, transient synovitis of the hip, and the recently discussed (Merle d'Aubigné 1964) idiopathic avascular necrosis of the femoral head in adults. That there is an etiological relationship between osteochondritis dissecans and coxa plana seems clear, but much more work is required before we will have at hand the patho-physiological evidence that will permit an accurate correlation of these two conditions.
PHLEBOGRAPHY IN OSTEOARTHRITIS OF THE HIP
Authors: Phillips R. S. 
Published: February 2018

1. Phlebography has been done on seven hips showing no radiological evidence of osteoarthritis. The findings largely confirm the work of previous authors. 2. Thirty-seven osteoarthritic hips have been examined in the same way. As the degenerative process worsens radiologically so the pattern of venous drainage deviates further from the so-called normal. 3. An attempt is made to explain the phlebographic findings in the light of known facts of the pathology of the disease.
CAUDA EQUINA AND SPINAL CORD COMPRESSION IN PAGET'S DISEASE
Authors: Klenerman L. 
Published: February 2018

1. Three patients with backache and spinal cord or cauda equina compression due to Paget's disease of the vertebrae are reported; all three were relieved by laminectomy. 2. One case is of particular interest because it is only the second one reported where compression was due to a single affected vertebra.
SKIN ARTHROPLASTY AS A POSSIBLE MEANS OF MOBILISING A TUBERCULOUS HIP
Authors: Karlen A. G. , Gunn D. R. 
Published: February 2018

1. In seventeen cases of tuberculosis of the hip in children with severe destruction of the joint arthroplasty was done using full thickness skin from the abdominal wall as the interposing material. 2. The results, after a follow-up on the average of three years, show that one-third of the cases are very satisfactory, one-third are fair and one-third show no movement.
A CONTRIBUTION TO THE DIFFERENTIAL DIAGNOSIS OF HURLER'S DISEASE AND FORMS OF MORQUIO'S SYNDROME
Authors: Bitter T. , Muir Helen , Mittwoch Ursula , Scott J. D. 
Published: February 2018

1. Mucopolysaccharides were analysed in the urine of thirteen patients with Morquio's syndrome aged between three and fifty-nine years and of fourteen controls of comparable ages. 2. There were no significant qualitative or quantitative differences between patients and controls. 3. The clinical and radiological findings suggested that these patients did not have the "Morquio-Ullrich" form of the disease, which appears on retrospective assessment of case reports to be more uniform and less diffuse than the Morquio-Brailsford form which may include a number of possibly unrelated diseases. 4. Keratosulphate has so far been demonstrated in the urine only of patients with the "Morquio-Ullrich" form of the disease, although the mucopolysaccharide excretion has been investigated in only a few patients with the Morquio-Brailsford form. The normal mucopolysaccharide excretion of the present series of patients suggests that a normal mucopolysaccharide excretion distinguishes the Morquio-Brailsford from the Morquio-Ullrich form, the latter having a number of features overlapping with Hurler's disease, where large amounts of mucopolysaccharide other than keratosulphate are excreted. 5. Both qualitative and quantitative analysis of urinary mucopolysaccharide are thus necessary to distinguish between Hurler's disease, the Morquio-Ullrich form and the Morquio-Brailsford's form of Morquio's syndrome.
THE TREATMENT OF CONGENITAL CLUB FOOT
Authors: Blockey N. J. , Smith M. G. H. 
Published: February 2018

1. The results of treatment of 186 club feet have been reviewed. 2. Early strong repeated manipulation and splintage produced correction in all, but only sixty-five out of 186 remained acceptable at three years. The other 121 relapsed. 3. Relapse occurred in the first year in eight, between twelve and eighteen months in twenty-five, between eighteen and twenty-four months in twenty-three, and between twenty-four and thirty-six months in sixty-five. 4. Relapse was slightly commoner when treatment began after the first month of life. 5. Relapse was treated either by manipulation and plaster or by soft-tissue correction, leaving fifty-two out of 121 acceptable at three years and sixty-nine which were not acceptable (this includes those in plaster after soft-tissue correction, necessitated by relapse around the ages of two and a half and three and is thus adversely loaded). 6. The three year results in 186 feet were studied: 63 per cent were acceptable and 37 per cent were not. Five year results in eighty-seven feet were studied: 87·4 per cent were acceptable and 12·6 per cent were not. 7. Soft-tissue correction is described. It produced 89 per cent acceptable feet but 11 per cent relapses in 280 operations.
NON-TRAUMATIC PROGRESSIVE PARALYSIS OF THE POSTERIOR INTEROSSEOUS NERVE
Authors: Mulholland R. C. 
Published: February 2018

1. A case of spontaneous posterior interosseous paresis is reported. It is suggested that the cause was replacement fibrosis secondary to local ischaemic damage from unremembered minor trauma. 2. In a patient with a posterior interosseous nerve paresis examination may reveal a space-occupying lesion near the elbow along the course of the nerve thus compressing it. Recovery may be expected after its removal. Consequently the nerve should be explored before resort to tendon transfers.
NON-UNION OF OBLIQUE DISPLACEMENT INTERTROCHANTERIC OSTEOTOMY FOR OSTEOARTHRITIS OF THE HIP
Authors: Scott P. J. 
Published: February 2018

1. The rate of non-union of 100 intertrochanteric osteotomies of the McMurray type, with internal fixation, is reported. One in five was not united one year after operation. The criteria of union are discussed. 2. The patient's disability in twelve ununited osteotomies has been assessed, and related to the mobility of the osteotomy. 3. The factors which prejudice union have been analysed. The principal cause of non-union appeared to be the varus angulation strain on a varus osteotomy displaced medially more than half the diameter of the bone. Obliquity inwards and upwards of the osteotomy was a contributory factor. The types of internal fixation used, the use of external splintage and the period of protected weight bearing with crutches did not appear to be related to the rate of union. 4. It is concluded that marked inward displacement of the osteotomy, combined with either obliquity of the osteotomy or a varus position, prejudices union; that the use of this technique is unfounded in principle and not supported empirically; and that displacement should be eschewed to avoid this complication of intertrochanteric osteotomy in the treatment of osteoarthritis of the hip.
ARTHROPLASTY OF THE FOREFOOT
Authors: Kates Alexander , Kessel Lipmann , Kay April 
Published: February 2018

1. The technique and results of arthroplasty of the metatarso-phalangeal joints for the grossly deformed forefoot are described. 2. The early results are very encouraging. 3. Attention is drawn to some of the complicating problems in rheumatoid arthritis, particularly the hazard of arteritis.
THE FEATURES OF FRACTURE HEALING IN CATS AFTER IMMEDIATE AND DELAYED OPEN REDUCTION
Authors: Emery M. A. , Murakami H. 
Published: February 2018

1. Clinical studies in humans have indicated that a delay of one to three weeks in the open reduction of a fracture decreases the incidence of delayed union and non-union. 2. Studies in cats indicate that a delay of two weeks before open reduction causes a different repair mechanism from that following immediate operation. 3. Repair after delayed operation is characterised by increased periosteal new bone formation and more rapid endochondral bone formation. After immediate operation periosteal new bone is slow to develop; much more fibrous tissue and cartilage develop, followed by slow endochondral bone formation.
THE BOUTONNIèRE DEFORMITY
Authors: Souter W. A. 
Published: February 2018

1. A series of 106 central slip injuries has been reviewed. 2. Although the boutonnière deformity in many cases may be no more than a cosmetic defect, this survey has shown that in some instances it can constitute a slowly progressive lesion, with considerable disability and gross deformity of a digit. 3. Conservative treatment seems to be superior to operation, at least in those patients seen within six weeks of injury. Treatment by splintage alone yielded in this series a 75 per cent success rate, whereas operation showed only 50 per cent success. 4. When a sizeable fragment of bone has been avulsed from the middle phalanx, suture of the fragment in position is indicated and gives remarkably satisfactory results. 5. Injuries with soft-tissue loss over the proximal interphalangeal joint may yield successful results after suture or plastic repair of the tendon, and wound closure by split-skin grafts or local rotation flaps. 6. Poor results tend to occur in cases complicated by phalangeal fracture or by multiple hand injuries, and it may be advisable to defer the repair of the central slip until recovery from the other injuries has been completed. 7. With gross disruption of the proximal interphalangeal joint primary arthrodesis is probably indicated.
PARALYTIC DEFORMITY IN THE LOWER LIMB
Authors: Sharrard W. J. W. 
Published: February 2018

1. The nature of paralytic deformity arising in poliomyelitis, cerebral palsy and spina bifida is considered and three types of deformity–acute contracture, postural contracture and deformity from muscle imbalance are described. 2. The place of physiotherapy, splintage and surgery in the management of these varieties of paralytic deformity is discussed and the overall results of treatment are reviewed.
MASSIVE OSTEOLYSIS OF THE HUMERUS TREATED BY RESECTION AND PROSTHETIC REPLACEMENT
Authors: Poirier H. 
Published: February 2018

1. A case of massive osteolysis of the right humerus is described. Diseased bone was resected leaving only the lower part of the humerus. The resected bone was replaced by a titanium prosthesis. 2. The diagnosis, etiology, prognosis and treatment of the condition are briefly discussed.
THE ACTION OF THE ILIOPSOAS MUSCLE IN THE NEWBORN
Authors: McKibbin B. 
Published: February 2018

1. Dissections of the newborn child revealed that the psoas muscle is a lateral rotator of the hip in all positions but that this secondary action is much stronger when the limb is abducted. 2. It has also been shown that the iliacus portion of the muscle can contribute towards the completion of abduction movement. 3. An attempt has been made to reconcile these facts with the accepted concept of the action of the muscle in the adult. 4. The clinical significance is discussed.
CONGENITAL LATERAL DISLOCATION OF THE PATELLA
Authors: Green J. P. , Waugh W. 
Published: February 2018

1. Four cases of congenital lateral dislocation of the patella are described. 2. The significance of the associated flexion contracture is emphasised. 3. Early diagnosis and operative realignment of the extensor mechanism is considered to be important because it should avoid the secondary growth changes which can produce serious disability.
THE EFFECT OF EXPERIMENTAL EPIPHYSIODESIS ON GROWTH IN LENGTH OF THE RABBIT'S TIBIA
Authors: Hall-Craggs E. C. B. 
Published: February 2018

1. Experimental epiphysiodesis was performed on either the upper or lower epiphysial cartilage of one tibia of young rabbits, the other tibia serving as a control. 2. Subsequent growth was observed at each epiphysis by radiography. 3. After both operations the normal deceleration of growth rate of the uninjured epiphysis on the experimental side was reduced and this epiphysis made a greater contribution than its control to the final length of the bone. 4. Serial sections of the injured epiphysis revealed that the arrest of growth was due to the formation of a narrow bony bridge between the epiphysial and metaphysial bone. 5. The additional growth of the uninjured epiphysis appeared to have a direct relationship to the deficiency of growth at the epiphysis that had been injured by operation. 6. The results may indicate the existence of a local system of growth control.
EFFECT OF ENVIRONMENTAL FACTORS ON THE REPAIR OF BONE IN VITRO
Authors: Prasad G. C. , Reynolds J. J. 
Published: February 2018

1. The use of a protein-free synthetic medium has provided a new technical approach to the study of fracture healing in vitro. 2. The tibiae of fourteen-day embryonic chicks were cut in half in the middle of the shaft, the fragments were placed in apposition and the explants grown in vitro for up to sixteen days. The process of bone repair was studied by means of histology and biochemical estimations. 3. The rate of growth in length of fractured bones was greater in an atmosphere containing 50 per cent of oxygen than in one with 20 per cent oxygen, thus emphasising the importance of an adequate oxygen supply for the regeneration of osteogenic cells. 4. The effect of varying the concentration of glucose in the medium was investigated. Two milligrams of glucose per millilitre was the most favourable for healing; higher levels caused fibroblastic changes in the cartilage cells and inhibited the proliferation of osteogenic cells at the fracture site. 5. Histological examination showed that many of the phenomena that occur in the repair of fractures in vivo can be reproduced in vitro in synthetic medium. Similar results were obtained whether the fracture was made in whole bones or in isolated shafts from which the cartilaginous ends had been removed; the latter are more favourable for biochemical study.
THE MANAGEMENT OF DEFORMITY AND PARALYSIS OF THE FOOT IN MYELOMENINGOCELE
Authors: Sharrard W. J. W. , Grosfield I. 
Published: February 2018

1. Deformities of the foot in children with myelomeningocele are described and classified. The results of a policy of operative correction of deformity in 148 patients all of whom had had at least one operation on the foot between 1947 and 1965 are described. 2. In 241 feet in which there were deformities 433 operations were performed, including tenotomies, soft-tissue divisions, tendon transfers and bony procedures. At the time of review successful correction of deformity had been obtained in 81 per cent with a plantigrade foot that could bear weight safely, and with a distribution of muscle activity that required minimal external support and presented the least liability to recurrent deformity. 3. The management of individual deformities is described and the causes of failure are analysed and discussed.
FRACTURE HEALING IN COMPRESSION OSTEOSYNTHESIS IN THE DOG
Authors: Olerud Sven , Danckwardt-Lillieström Göran 
Published: February 2018

1. The healing of the radius and tibia in dogs after compression plating of osteotomies made by a Gigli saw was studied. 2. The methods used were indian ink microangiography and terramycin labelling. The Spalteholz technique and azane colouring were used. 3. Revascularisaton of the fracture region took place both from newly formed vessels in the Haversian systems and from periosteal and endosteal vessels. 4. The fracture gap was filled at an early stage by a vascular network. Under stable conditions direct angiogenic bone formation took place around this network. 5. Rebuilding of the cortical bone in the fracture region occurred by osteoclastic activity. Groups of osteoclasts made cavities in the necrotic bone and were immediately followed by loops of vessels; behind and around the loop new bone was formed. Another form of bone absorption consisted of bundles of vessels which eroded necrotic cortical bone without new bone formation. 6. The new bone was initially oriented along the fracture gap but, by conversion into secondary osteones, it became progressively oriented longitudinally in the direction of the original bone. 7. Under stable conditions some periosteal and endosteal callus formation occurred though it was of slight importance. It regressed very soon and was seldom seen in the radiographs.
ANTERIOR CERVICAL DISCECTOMY AND FUSION
Authors: Simmons Edward H. , Bhalla S. K. , Butt W. P. 
Published: February 2018

1. A series of 154 patients who underwent anterior cervical discectomy and fusion has been studied. A detailed analysis of the first eighty-four patients who have been observed for periods of from one to eight and a half years is described. In sixty-eight patients the fusion was done with a keystone type of graft, in seventeen by a dowel (Cloward) graft. 2. Despite a preponderance of multiple level fusions in the keystone series, clinically better results (80·8 per cent excellent or good) were found in this group than in the dowel group (64·8 per cent excellent or good). 3. A biomechanical study has indicated the keystone graft to be more stable than a dowel graft under flexion and extension strains as well as lateral bending strain. The graft is more stable the closer it is to the line of "zero velocity." 4. The three cases of non-union all occurred in the dowel group. The high incidence of fusion with the keystone technique is considered to be related to the type of graft, its method of seating, its depth of penetration, its larger surface area and the fact that raw cancellous bone of the adjacent vertebral bodies is in contact with the graft above and below.
DISLOCATION AND DEFORMITY OF THE HIP IN CHILDREN WITH SPINA BIFIDA CYSTICA
Authors: Menelaus M. B. 
Published: February 2018

1. Paralytic dislocation of the hip in spina bifida generally requires reduction and iliopsoas transfer. The muscle transfer ensures that the hip remains reduced, lessens the need for calipers and prevents progressive flexion deformity. In addition, varus and rotation osteotomy of the femur and innominate osteotomy are sometimes required. Varus and rotation osteotomy alone is indicated if the psoas is not strong enough for transfer. The age for reduction of dislocated hips and muscle transfer has been reduced to eight months as experience and confidence has been gained. 2. Flexion deformity is best prevented by early iliopsoas transfer. An anterior release operation is occasionally indicated when there is flexion deformity and a weak psoas muscle. This procedure, alone or supplemented by extension osteotomy, may be necessary to correct severe flexion deformity in children seen late. 3. Lateral rotation deformity of the hip may be caused by unbalanced iliopsoas action or the unbalanced action, or contracture, of the short lateral rotator muscles. If the deformity is sufficient to make the gait bizarre, or if it is difficult to fit a caliper, then soft-tissue operations as described are of value. 4. Abduction deformity can be corrected by division of the unopposed or contracted abductors.
PYCNODYSOSTOSIS
Authors: Emami-Ahari Z. , Zarabi M. , Javid B. 
Published: February 2018

1. A patient is described, the thirty-fourth reported, who shows all the skeletal changes of pycnodysostosis with the exception of the oral findings. 2. It is suggested that the pseudarthroses of the tibiae in our patient cannot be taken as evidence against normal union because of the possibility of inadequate management of the fractures. 3. We consider that the use of strong intramedullary nails in the treatment of long bone fractures in these cases is advisable.