bluuebunny/crossref_metadata_2025_split huggingface dataset:
FRACTURES OF THE TIBIAL SHAFT
Authors: Nicoll E. A. 
Published: February 2018

1. A series of 705 fractures of the tibia is reviewed, 674 of which were treated conservatively. 2. The factors most conducive to delayed or non-union are initial displacement, comminution, associated soft-tissue wound and infection. The extent to which these are combined in any fracture determines its "personality" and its inherent propensity for union. 3. Eight fracture types are differentiated based on the above "personality rating." The incidence of delayed union or non-union varies from 9 per cent in the most favourable type to 39 per cent in the least favourable. Infection raises the incidence to 60 per cent. Comparative statistics which fail to recognise these differences can be entirely misleading. 4. Continuous traction does not retard union. 5. The results of conservative treatment are analysed with regard to union, deformity, stiff joints and contractures and the conclusion is reached that no case has yet been made out for internal fixation as the method of choice in the treatment of this fracture.
TREATMENT OF FOREARM FRACTURES IN ADULTS WITH PARTICULAR REFERENCE TO PLATE FIXATION
Authors: Nevile Burwell H. , Charnley Arnold D. 
Published: February 2018

1. A simple method of internal fixation of adult forearm fractures which gives consistent good results is necessary because the closed method of treatment is of limited application. 2. Open reduction of fractures without rigid internal fixation gives a high proportion of non-union and poor results. 3. Rigid internal fixation with standard plates and screws has been shown to give a low incidence of non-union in this series. 4. A three and a half inch long plate with six screws is suitable for most fractures, but if there is moderate or severe comminution, or if there is a segmental fracture, longer plates and more screws should be used to provide sound fixation. 5. Severely comminuted fractures with large avascular bone fragments should have the addition of a bone graft at the time of the plating operation in order that union may be assured. Thin strips of iliac bone are preferred. 6. Rigid plating is considered to be the most satisfactory treatment for open fractures. 7. Immobilisation of the limb after operation is not necessary and is undesirable if the fixation is rigid. 8. The functional results of this treatment are good and seemingly better than those achieved by other methods. 9. Serious complications of the plating operation are few and avoidable.
TALIPES EQUINOVARUS
Authors: Wynne-Davies Ruth 
Published: February 2018

1. A long-term follow-up of eighty-four patients with talipes equinovarus is reported. 2. A detailed examination was made to ascertain the nature of the residual deformity and assess the function of the deformed foot. 3. Radiographic technique in infants and adults is described. 4. Results showed that: 1) In many cases there was a dysplasia of the whole limb. 2) The dysplasia was no more marked in the patients treated in the early 1930's by multiple forceful under anaesthetic, than in the more recent patients treated by gentler means. 3) Nearly half the cases had only a false correction of the deformity in that the foot was "broken" at the talo-navicular level, leaving the heel in inversion, although the forefoot was plantigrade. 5. The posture of patients with laterally rotated hip joints is related to the fixed inverted heel. 6. Clinical assessment correlated with radiographic appearances shows clearly the near impossibility of a good foot resulting from a false correction.
CONTRACTURE OF THE QUADRICEPS MUSCLE
Authors: Gunn D. R. 
Published: February 2018

1. Contracture of parts of the quadriceps muscle is not uncommon and is often accompanied by tightness of the ilio-tibial tract. It is suggested that this may follow intramuscular injections. 2. Recurrent dislocation of the patella can be a consequence of this muscle contracture. 3. Division of the ilio-tibial tract and lengthening of the fibrotic elements of the quadriceps can prevent further dislocation and restore good function.
THE BONDING OF PROSTHESES TO BONE BY CEMENT
Authors: Charnley John 
Published: February 2018

1. The use of acrylic cement in bonding femoral head prostheses to bone is described. 2. No sign of deterioration of the bond between the cement and bone has been seen in histological preparations up to three and a quarter years after operation, and no harmful effects have been recognised, or suspected, in 455 patients in whom it has been used. 3. The technique is considered justifiable in elderly patients where the medullary canal is large and the cortex of the femur is thin and brittle.
TRANSCERVICAL FEMORAL FRACTURE
Authors: Brown J. T. , Abrami G. 
Published: February 2018

1. A review of 195 patients with displaced intracapsular fractures of the femoral neck treated by a sliding nail-plate appliance has been presented. 2. The highest failure rate was evident in fractures in women over seventy-five with Grade 4 displacement. 3. The effect of various concomitant factors has been analysed in relation to the end results. 4. Observations have been made on avascular necrosis, its incidence amongst the failures and its association with late segmental collapse after fracture union.
SPONTANEOUS BILATERAL RUPTURE OF THE CALCANEAL TENDON DURING STEROID THERAPY
Authors: Melmed E. P. 
Published: February 2018

1. This case is presented to illustrate two etiological factors in tendon rupture occurring in one patient. 2. The rupture of the long head of the biceps brachii muscle appears to have been of acute traumatic origin. 3. Bilateral simultaneous rupture of the calcaneal tendons is rare, but it seems probable that the cortico-steroid therapy was the etiological factor in this case. 4. It has been suggested that degeneration in the tendon is caused by ischaemia, secondary to hypertrophy of the tunica media and narrowing of the medium calibre blood vessels. Betamethazone could possibly have aggravated, or may even have caused these changes, and the periarteriolar changes found in the biopsy specimen would tend to support this theory.
VERTEBRAL FRACTURES IN WEST AFRICANS SUFFERING FROM TETANUS
Authors: Davis P. R. , Rowland H. A. K. 
Published: February 2018

1. Radiography of the spines of thirty-three West African patients recently recovered or dead from tetanus revealed vertebral fractures in nineteen. These fractures occurred most frequently in the fourth to eighth thoracic vertebrae. 2. The spines of 111 Nigerians from the same area of West Africa were examined, measurement of the areas and shape of the vertebral bodies carried out, and the proportional incidence of articular shelves and laminar spicules was calculated. 3. The upper mid-thoracic vertebral bodies are relatively long and narrow and have but little greater cross-sectional area than those immediately above them; possessing no neural arch supports to sustain longitudinal compressive forces in flexion, they are at greatest hazard during tetanic spasms. 4. Analyses of these factors and of the clinical features, together with experimental observations drawn from the literature, are used to explain the prevalence of upper mid-thoracic vertebral fractures as a complication of tetanus in West Africans, and in particular the greater degree of compression and higher incidence found in children. 5. Vertebral fracture is not usually an important complication of tetanus; it causes little pain, does not prolong the illness, gives rise to no permanent disability and has no effect on the mortality.
TREATMENT OF DISPLACED SUPRACONDYLAR FRACTURES OF THE HUMERUS IN CHILDREN IN FULL EXTENSION AND SUPINATION
Authors: El-Sharkawi A. H. , Fattah H. Abdel 
Published: February 2018

1. A method of treatment of displaced supracondylar fractures of the humerus in children by manipulative reduction and fixation in plaster in full extension of the elbow and supination of the forearm is described. 2. The method is easy, safe and requires a short period of hospitalisation. The carrying angle at the elbow can only be recorded, controlled and maintained when the elbow is extended and the forearm is fully supinated. Thus cubitus varus can be avoided. 3. The results of treatment in seventy-two displaced fractures treated by this method are reported. 4. Treatment by other methods is reviewed.
THE FUNCTION OF FIBROCARTILAGINOUS FRACTURE CALLUS
Authors: Urist Marshall R. , Wallace Theodore H. , Adams Thompson 
Published: February 2018

1. Autografts, isografts and homografts of fibrocartilaginous callus were observed in the anterior chamber of the eye in rats. Proliferation of cartilage ceased, endochondral ossification followed, and the end-product was a new and complete ossicle with a cortex and a marrow cavity. The size and shape of the ossicle was determined by the size and shape of the sample of callus. Thus the callus in the eye performed the function of a cartilage model like that of the developing epiphysis or a healing fracture of a long bone. 2. Fibrocartilaginous callus, heavily labelled with 3H-thymidine, was transplanted to the eye twenty-four hours after the last injection, when there was little if any radioactive thymidine circulating in the blood. A few small chondrocytes with labelled nuclei persisted in the cores of new bone trabeculae, but the largest part of the labelled callus was resorbed and replaced by unlabelled new bone. 3. Homografts of labelled callus produced the same results as autografts at twenty-five days, but between twenty-five and forty-five days the donor cells were destroyed by the immune response of the host. 4. Isogenous transplants in host rats treated with 3H-thymidine between nine and thirteen days, when the callus was invaded by new blood vessels, produced many osteogenetic cells with labelled nuclei and made it possible to trace the origin of the new bone. The label appeared in the progenitor cells within twenty-four hours. While remaining thereafter in progenitor cells, it appeared also in osteoclasts (or chondroclasts) and osteoblasts in forty-eight to seventy-two hours, and in osteocytes in ninety-six to 120 hours. Chondrocytes did not proliferate and were not labelled in the eye. 5. Homogenous transplants in host rats treated with 3H-thymidine between five and one days before the operation also produced new bone, but contained no labelled osteoprogenitor or bone cells after twenty-five days in the eye. At forty-five days the donor tissue had been destroyed by the immune response of the host. 6. Devitalised callus was encapsulated in inflammatory connective tissue and scar. When the dead callus was absorbed by the capillaries of the host new bone formation by induction produced a scanty deposit as a delayed event in a few instances. 7. Irrespective of whether it originated in the donor or the host, a connective-tissue cell type that proliferated rapidly and became labelled with 3H-thymidine was identified as a progenitor cell. Differentiation and specialisation as osteoprogenitor cells occurred after the growth of blood vessels into the interior of the callus, and developed inside of excavation chambers in cartilage. Except that the interaction of the donor tissue and host cells leading to new bone formation by induction takes place in the interior of the excavation chamber, the biophysico-chemical mechanism is unknown.
VASCULARISATION OF BONE GRAFTS IN THE ANTERIOR CHAMBER OF THE EYE
Authors: Deleu J. , Trueta J. 
Published: February 2018

In this study the direct relationship between the type of bone implant used, the vascular reaction caused to the host and the revascularisation of the implant has been studied. It was found that the best graft was that which was the most rapidly and permanently vascularised. Not only was the biological affinity between the graft and the bed important, but the structural facilities offered by the implant for the "penetration" by the host vessels were also of paramount importance. Thus small, fresh, cancellous bone grafts offered the best chance of rapid incorporation provided they were not crushed to the point of making vascular progress difficult. The findings from this investigation so strongly suggest that the rapid revascularisation of the bone grafts was because of an end-to-end anastomosis of the vessels of the host with those in the implant that it seems justified to consider that the best bone graft is that which is richest in vessels. Apart from a recent short paper by Graf (1960), we have not found this assertion before. It is this which seems to make the fresh, autogenous, cancellous implant so superior to all others. We believe that any new material for bone grafts should be tested by the technique described here. The material which one day may replace fresh, autogenous, cancellous implants will have to show the same readiness to vascular penetration, vascular osteogenesis and vascular permanency that at present is exhibited only by the cancellous autograft.
SUBTROCHANTERIC OSTEOTOMY IN THE TREATMENT OF PERTHES' DISEASE
Authors: Axer A. 
Published: February 2018

1. A rationale of subtrochanteric osteotomy with derotation and varus angulation in the treatment of Perthes' disease is suggested. 2. Three months after operation the child returns to a normal unrestricted life. 3. The anatomical results in twelve such operations with an average follow-up of two years and five months are presented. In five children the results were "very good," in four "good," in one "fair" and in one "bad." 4. These results seem to compare favourably with those observed after conservative treatment of two, three or more years duration.
LATE THROMBOSIS OF THE FEMORAL ARTERY COMPLICATING FRACTURE OF THE FEMUR
Authors: Roper B. A. , Provan J. L. 
Published: February 2018

1. A case of femoral artery occlusion after fracture of the femur occurring several days after internal fixation with a medullary nail is described. 2. Arterial reconstruction was undertaken seventeen days after the internal fixation, twenty-seven days after the injury, with restoration of flow and recovery of the limb.
IDIOPATHIC NECROSIS OF THE FEMORAL HEAD IN ADULTS
Authors: d'Aubigné R. Merle , Postel M. , Mazabraud A. , Massias P. , Gueguen J. 
Published: February 2018

1. Idiopathic necrosis of the femoral head is generally considered to be a rare disease but it appears to be rather frequent in France in view of the fact that 139 cases were recorded in the orthopaedic clinic of Hôpital Cochin between 1959 and 1963. Ninety cases treated by operation have been analysed in this paper. Men are nearly exclusively affected between the ages of eighteen and seventy, with the highest incidence between thirty and fifty years of age. Both hips are affected in 52 per cent of cases. 2. The etiology is unknown, but steroid therapy was noted in 36 per cent of the cases and some history of slight injury in 30 per cent. The sudden onset of pain in half the cases suggests the obliteration of one of the blood vessels supplying the femoral head. 3. Radiographs are often normal at the time of onset of the symptoms but later they show increased density of the head localised to the antero-superior aspect, and later still collapse of this weight-bearing region. The extent of the lesion appears to be determined from the very beginning rather than to be progressive. The superior joint space is never reduced and may in fact be widened. 4. Pathological examination of the head and neck confirms necrosis of the cancellous bone and the integrity of the overlying cartilage, but shows deep to the necrotic region a highly reactive zone characterised by hypervascularity and raised metabolism. These features have been demonstrated by injection of the blood vessels and also by the uptake of phosphorus 32 and by the succino-deshydrogenase test. 5. In six cases microscopic vascular lesions were found in the antero-lateral pedicle of the femoral head. 6. The high degree of activity of the tissue deep to the necrotic zone gives some hope for revascularisation of the necrotic segment. For this reason protection from pressure may be the way to prevent dramatic collapse of the head. Rest, medical treatment and freedom from weight bearing, however, do not achieve adequate protection. Varus or rotation osteotomy of the femoral neck not only gives relief from pain but appears to prevent collapse of the femoral head. 7. When destruction of the head has already taken place good results may be expected from the insertion of a metallic prosthesis, provided the acetabulum is sound. The results are less favourable when the acetabulum has been altered by secondary arthritic change, and arthrodesis may have to be considered if the disease is unilateral or when a prosthesis has been successfully inserted on the other side.
A NEW METHOD OF HIP FUSION USING AN INTRAMEDULLARY NAIL
Authors: Onji Yutaka , Kurata Yotaro , Kido Hikaru 
Published: February 2018

1. A method of hip fusion with the aid of a straight intramedullary nail through the ilium and the femur is presented. 2. If properly done, no external fixation is necessary and the patient can be allowed up with crutches ten days after the operation. 3. The method has been used on eighteen hips between 1958 and 1960. There was one case of delayed union due to faulty technique and one case of exacerbation of an old tuberculous infection. Otherwise the follow-up study of the patients revealed good bony fusion in all cases, with no pain in the back or knee.
GIANT-CELL TUMOURS AND ANEURYSMAL BONE CYSTS OF THE SPINE
Authors: Verbiest H. 
Published: February 2018

1. Five cases of involvement of vertebrae by growths classified as giant-cell tumours, and two cases of involvement by tumours classified as aneurysmal bone cysts are described. 2. The periods of observation after operation in the benign cases were in three cases six years, in one ten years and in one twenty-one years. 3. In one case malignant transformation developed four and a half years after operation and one patient, in whom a sacral tumour was already malignant at the time of operation, died five months later. 4. Four patients showed significant involvement of vertebral bodies. 5. The problems related to the removal of a vertebral body and the measures taken to stabilise the spine are discussed.
THE HISTOLOGICAL APPEARANCES OF LATE SEGMENTAL COLLAPSE OF THE FEMORAL HEAD AFTER TRANSCERVICAL FRACTURE
Authors: Catto Mary 
Published: February 2018

1. A study of late segmental collapse in twelve femoral heads shows that it may not develop until two and a half years after the fracture. 2. Until the articular surfaces had collapsed the patients usually had no symptoms. The fractures were united and there was no obvious radiographic evidence of ischaemic necrosis. 3. There was histological evidence that the whole of the femoral heads had been necrotic at one time. The term late segmental collapse is more appropriate than late segmental necrosis. 4. The blood vessels of the ligamentum teres played little or no part in revascularisation which, when it occurred, was almost entirely across the fracture line. 5. In only one femoral head was revascularisation approaching completion and apparently continuing. In the other eleven much of the head remained necrotic and the process appeared to have halted. 6. An increase in radiological density was caused by new bone laid down on unresorbed necrotic trabeculae and was most prominent behind the line of revascularisation when the process had halted. 7. Trabecular collapse was evident within dead bone. In ten of the femoral heads it occurred in the subchondral region and in four just beyond the junction of reossified and dead bone. 8. Osteoarthritic changes occurred in the cartilage covering revascularised bone at the periphery of the head, especially when collapse was severe.
THE MANAGEMENT OF INFECTION AFTER KÜNTSCHER NAILING OF THE FEMUR
Authors: Wilson J. N. 
Published: February 2018

1. Seven cases of infection following medullary nailing of the femur have been studied. 2. Points in the diagnosis of nail track infection are emphasised, especially periosteal reaction. 3. It is felt that a sinograph is an essential part of the investigation and can be useful to assess progress. 4. The principles of treatment of established nail track infection are: adequate drainage of the fracture site; dependent drainage of the whole track by draining the pocket at the lower end; the use of instillation tubes to irrigate the nail track with antibiotics. Once the fracture is stable and the nail track adequately treated by local and general antibiotics the nail should be removed. It is not considered necessary to wait for bony union before removal of the nail.
OSTEOSARCOMA IN ENCHONDROMATOSIS (OLLIER'S DISEASE)
Authors: Braddock G. T. F. , Hadlow V. D. 
Published: February 2018

1. A patient of sixty-eight suffering from enchondromatosis (Ollier's disease) is described. 2. A malignant tumour developed in the region of the lesser trochanter of the femur. Histological investigation established that it was an osteosarcoma. 3. Other features of interest are the radiographic appearance of Ollier's disease at an advanced age, and the presence of subcutaneous subcostal and retroperitoneal haemangiomata.
A METHOD OF ASSESSING CORRECTION IN CLUB FEET
Authors: Beatson T. R. , Pearson J. R. 
Published: February 2018

We suggest that, after an initial course of treatment in the accepted manner by gentle manipulations without anaesthetic, followed by splinting for a period of three or four months, the talo-calcaneal index should be measured on radiographs taken in the standard positions described. Should the correction be inadequate–that is, should the talo-calcaneal index be under 40 degrees even though clinically the foot appears corrected–further treatment should immediately be undertaken.
RESTORATION OF PREHENSION AFTER SEVERE MUTILATIONS OF THE HAND
Authors: Tubiana Raoul , Stack H. Graham , Hakstian Robert W. 
Published: February 2018

1. Prehension is a complex mechanism for which both movement and sensation are required. 2. Two basic grips are considered: the digital pinch and palmar grasp, which are simpler expressions of the precision grip and the power grip. For the digital pinch the minimum requirement is a thumb or a reconstructed thumb, and a finger to which it can oppose. For palmar grasp mobile fingers are necessary so that they can wrap round the object grasped. 3. The restoration of prehension is considered under the following headings: mutilation of the fingers; mutilation of the thumb; and mutilation of both together. 4. The various methods of reconstruction are described that are appropriate to each type of mutilation, so as to provide restoration of length, mobility and sensation. 5. The indications for the various main methods to compensate for loss of the thumb are discussed. These methods include pollicisation and osteoplastic repair with neurovascular island flap.
MASSIVE OSTEOARTICULAR BONE GRAFTS
Authors: Ottolenghi Carlos E. 
Published: February 2018

1. Seven cases of massive osteoarticular transplant for conditions affecting major joints are described. In one case the whole femur was replaced. 2. The transplants were well accepted, though there was a varying degree of absorption of bone and necrosis of articular cartilage. 3. The functional results were very satisfactory, and movements of joints were well preserved. 4. In these cases recurrence of the original disease was not seen. 5. Such operations are still in an experimental stage, but they are likely to have a permanent place in treatment in certain carefully selected cases.