bluuebunny/crossref_metadata_2025_split huggingface dataset:
RECONSTRUCTION OF THE THUMB
Authors: Reid D. A. Campbell 
Published: February 2018

1. Absence of a thumb, whether congenital or due to injury, is a severe disability. Reconstructive surgery has much to offer. 2. Pollicisation is the most satisfactory method, being the only means of providing a thumb with normal tactile sensibility. The importance of this has often been overlooked and has been emphasised by Moberg (1958). Pollicisation offers also the best functional and aesthetic results. When applicable, the neurovascular pedicle technique of Littler is the one of choice. It is indicated in group 2 cases associated with a partly amputated finger, when this is swung on to the thumb stump, and for patients in groups 3 and 4 when the normal index finger is used. If this method is not feasible a staged pollicisation may be used instead. 3. The Gillies method of thumb lengthening has a more limited application, but it is valuable in selected cases. 4. Reconstruction by tubed pedicle and bone graft is seldom indicated and is best reserved for reconstruction in the mutilated hand when local elements are deficient. 5. Replacing a thumb by a toe should be reserved for exceptional cases. 6. Autografting the amputated thumb is feasible, and should be considered when the amputated digit has been preserved.
TREATMENT OF INEQUALITY OF THE LOWER LIMBS
Authors: Tupman G. S. 
Published: February 2018

1. The results are reported of a series of operations designed to stimulate growth of the bones of the lower limb by the insertion of pegs of bone or ivory close to the epiphysial cartilage. 2. The evidence is that growth was stimulated in twelve of twenty-eight patients. 3. Growth is more likely to be stimulated if the operation is done on children between the chronological ages of six and twelve.
THE VASCULAR CONTRIBUTION TO OSTEOGENESIS
Authors: Trueta J. , Amato V. P. 
Published: February 2018

In this work the role of the blood vessels surrounding the epiphysial growth plate has been studied. The nutritional dependence of the proliferative cells on the epiphysial vessels has been established whereas the metaphysial vessels were seen to take part in calcification and ossification at the metaphysis. As it does not seem likely that the blood circulating in the two systems of vessels had a different constitution, particularly in hormones and vitamins, it seems permissible to assume that it is the characteristics, particularly in shape and number, of such vessels that make growth the orderly process it is, with the repeated birth of a cell at the top of a column and burial at the bottom end. But, despite this undeniable role of the vessels, growth depends on the ability of the cartilage cell to form a matrix which, in due course, will be avid for apatite crystals.
CONGENITAL DISLOCATION OF THE HIP
Authors: Wilkinson John , Carter Cedric 
Published: February 2018

1. The histories of 149 patients, coming to the Hospital for Sick Children within the first three years of life with congenital dislocation of the hip (191 dislocated hips), and treated by conservative methods, have been reviewed. 2. The patients with unilateral dislocations (107) have been divided into three groups, according to the angle of slope of the opposite acetabulum. This angle was measured on the first radiograph and related to the mean value for age and sex. 3. The opposite hip was classed as "normal" if the acetabular angle was below or within one standard deviation above the mean for sex and age; as "moderately shallow" if it was between one and two standard deviations above the mean; and as "shallow" if it was over two standard deviations above the mean. This grouping was found to have a direct bearing on the results of conservative treatment in unilateral cases. a) Those with "normal" opposite acetabula–accounting for most of the unilateral cases–responded well. b) Those with "moderately shallow" opposite acetabula responded variably. c) The group with "shallow" opposite acetabula usually failed to respond. 4. Most bilateral dislocations behaved as unilateral dislocations with shallow opposite hips. 5. Additional factors influencing the response to conservative treatment–sex, age at first attendance, family history, fragmentation of the femoral epiphysis and eccentric reduction–are discussed.
HETEROTOPIC OSSIFICATION IN PARAPLEGIA
Authors: Damanski M. 
Published: February 2018

1. A clinical study has been made of heterotopic ossification in 273 patients with paraplegia of traumatic and non-traumatic origin treated at the Liverpool Paraplegic Centre over a period of twelve and a half years. 2. The literature is reviewed and theories of etiology are discussed. 3. Etiological factors have been studied. Prominent among these is inadequacy of early treatment leading to urinary infection and to the formation of pressure sores. 4. It is concluded that there is no effective treatment for established heterotopic ossification. 5. The importance of prophylactic treatment is stressed. Special emphasis is placed on adequate primary treatment, correction of hypoproteinaemia and early mobilisation.
RELAPSED CLUB FOOT
Authors: Evans Dillwyn 
Published: February 2018

1. An operation which can correct congenital club foot deformity in older children is described. 2. The operation is based on the assumption that the essential element in a complex tarsal deformity is a displacement of the navicular bone on the talus and that all other elements of the deformity are secondary and adaptive. 3. The results of the operation are noted and the implications of some of its effects are discussed.
RUPTURE OF THE AXILLARY ARTERY
Authors: Gibson J. M. C. 
Published: February 2018

1. Two cases of rupture of the axillary artery without dislocation of the shoulder or fracture of the neck of the humerus are reported, and the etiology is discussed. 2. The treatment of a ruptured axillary artery is primary repair, and not ligation. 3. In the repair of the artery the complete clearance of distal thrombus is most important; retrograde flushing is advised for this purpose.
ANTERIOR LAXITY OF THE ANKLE
Authors: Flint Michael H. , MacKenzie Ian G. 
Published: February 2018

1. Recurrence of deformity after operations for drop foot is often associated with opening of the front of the ankle joint: this has previously been regarded as a complication of the operation. 2. This study of sixty paralytic drop feet treated conservatively reveals that this laxity was in fact present in no less than 43 per cent. 3. The laxity is most commonly found when the calf muscle is strong and it can occur within a year of the onset of the paralysis. It is not always prevented by wearing a toe-raising spring. 4. Such anterior laxity may well be a common cause of failure of many of the standard operations for drop foot. 5. Before operation for drop foot is undertaken a lateral radiograph of the ankle should be taken in forced plantar-flexiori. If this demonstrates anterior laxity any standard operation is unlikely to succeed unless the anterior fibres of the collateral ligaments are protected from strain by simultaneous tendon transplantation or unless the ankle is included in the arthrodesis.
THE INCIDENCE OF OSTEOPOROSIS IN PATIENTS WITH FEMORAL NECK FRACTURE
Authors: Stevens Jack , Freeman P. A. , Nordin B. E. C. , Barnett Ellis 
Published: February 2018

1. Recently described histological and radiographic methods of diagnosing osteoporosis have been applied to patients with transcervical and intertrochanteric fractures of the femur. 2. Both methods indicate a higher incidence of osteoporosis in such patients than in a control series, especially in older women with intertrochanteric fractures. 3. A discrepancy between the results of biopsy and radiographic examination was encountered, the explanation of which is not yet clear.
RHEUMATOID HAND DEFORMITIES CONSIDERED IN THE LIGHT OF TENDON IMBALANCE. I
Authors: Vaughan-Jackson O. J. 
Published: February 2018

1. The posture of deformed finger joints in rheumatoid arthritis needs close analysis in terms of disturbed muscle balance. Although disorganisation of the joint itself may be the primary factor in the development of deformity, the deformity is often secondary to an extrinsic disturbance of muscle balance. 2. The part played by tendon ruptures in producing such imbalance is discussed.
THE SURGICAL TREATMENT OF HAEMOPHILIC BLOOD CYSTS
Authors: Hall M. R.P. , Handley D. A. , Webster C. U. 
Published: February 2018

1. The treatment of two haemophilic patients with cystic haematoma by radical surgical excision is described. 2. Details are given of their management after operation with the successful use of animal and human antihaemophilic globulin to control bleeding. 3. The literature of cystic haematoma in haemophilia is briefly reviewed and the seriousness of this condition stressed.
ACUTE PEPTIC ULCERATION AND CEREBRAL FAT EMBOLISM AFTER FRACTURE
Authors: Teare R. D. , Bowen D. A.L. , Drury R. A.B. 
Published: February 2018

1. Three cases of acute peptic ulceration are reported after cerebral fat embolism complicating skeletal injuries. In two instances death occurred after perforation of an ulcer, and in the third intestinal haemorrhage led to death. 2. Although intracranial lesions and peptic ulceration have been reported on many occasions, so far as we know cerebral fat embolism as a cause has not been previously recognised. 3. The possible pathogenesis is discussed.
OBSERVATIONS ON THE ETIOLOGY OF TIBIA VARA
Authors: Golding J. S. R. , McNeil-Smith J. D. G. 
Published: February 2018

1. Twenty-eight cases of the infantile and three cases of the adolescent type of tibia vara occurring in West Indian Negroes are reported. 2. The condition is characterised by failure of growth of the postero-medial part of the upper tibial epiphysis. 3. The deformity produced is acute varus at the upper tibia with medial torsion and eventually flexion of the diaphysis on the epiphysis. 4. These deformities are considered to be due to a vicious circle set up by considerable alteration of the lines of force on the medial portion of the upper tibial epiphysial line.
A NEW METHOD OF RESTORING SENSIBILITY TO THE THUMB
Authors: Holevich J. 
Published: February 2018

1 . A method of restoring protective sensibility to the thumb by a neurovascular pedicle graft is described. 2. The pedicle is taken from the dorsum of the index finger. 3. The method has been modified to include a racquet-shaped skin flap to give continuous sensibility from the pulp down the antero-medial border of the thumb.
FUNCTION OF THE SUPRASPINATUS MUSCLE AND ITS RELATION TO THE SUPRASPINATUS SYNDROME
Authors: van Linge B. , Mulder J. D. 
Published: February 2018

1. In ten healthy young men an experimental paralysis of the supraspinatus muscle was induced with the aid of Xylocaine injected in or near the suprascapular nerve. 2. The completeness of the paralysis was checked by electromyography. 3. With the supraspinatus muscle completely eliminated, all subjects could move the arm against gravity through its full range in the shoulder joint, though the force and the power of endurance during abduction were diminished. 4. It is concluded that the role of the supraspinatus muscle is of a quantitative nature only.
THE MECHANICS OF THE HIND FOOT IN CLUB FOOT AS DEMONSTRATED RADIOGRAPHICALLY
Authors: Heywood A. W. B. 
Published: February 2018

1. Lateral radiographs of fifty-seven club feet and seventeen normal feet were taken in forced flexion and forced extension. On these, the arcs traversed by the talus, the sole and the calcaneus were measured, as was the talo-calcaneal angle. 2. It was found that the ankle in club feet usually contributed more than half of the total sagittal movement of the foot. 3. Occasional cases were encountered in which the ankle was so damaged that it contributed only half or less than half of this movement. In such cases wedge excision of the ankle joint is theoretically justified in preference to wedge tarsectomy. 4. The talo-calcaneal angle is much reduced in club foot, and this element of deformity is extremely resistant to manipulative treatment. The reasons for this and a possible method of treatment are discussed.
THE EFFECT UPON THE INFERIOR RADIO-ULNAR JOINT OF EXCISION OF THE HEAD OF THE RADIUS IN ADULTS
Authors: Taylor T. K. F. , O'Connor B. T. 
Published: February 2018

1. Fifty-eight adult patients who had been treated for radial head fractures by excision of the head of the radius have been reviewed at periods varying between two and nineteen years after operation. 2. Symptoms referable to the inferior radio-ulnar joint were present in half of the patients and the mechanisms of the disorder in these patients are discussed in the light of a radiographic study. 3. We feel it justifiable to conclude from our observations that this complication of surgical treatment of radial head fractures deserves greater attention than has been given to it in the past, and that it is of sufficient importance to be taken into consideration when planning the management of these fractures, especially the less severe injuries. 4. Prosthetic replacement of the proximal end of the radius is the logical and, indeed, the only way in which the distal radio-ulnar joint subluxation can be avoided, but no clearly defined indications for the routine use of a prosthesis as a primary procedure can be suggested on the basis of this investigation.
POST-TRAUMATIC EROSIONS OF ARTICULAR CARTILAGE
Authors: Crock H. V. 
Published: February 2018

1. Sixteen patients with articular cartilage erosions after slight injury have been described, as have the results of their treatment. 2. The clinical features of this rarely diagnosed condition are discussed. Attention is drawn to "articular crepitus" and "synovial crepitus" as useful physical signs in establishing the diagnosis. 3. A radiographic sign of localised subarticular osteoporosis is reported and discussed. 4. The surgical treatment used was either shaving of the affected area of cartilage or a combination of shaving with drilling of the subchondral bone plate.
HEMIMELIC SKELETAL DYSPLASIA
Authors: Saxton H. M. , Wilkinson J. A. 
Published: February 2018

1. A case is reported of a Jamaican boy of fifteen months with typical and florid manifestations of dysplasia epiphysialis hemimelica associated with a number of atypical features not previously recorded. 2. The progress of the disorder over a limited period of two years is described and the development of the atypical features is discussed.
TRIANGLE PINNING FOR FRACTURE OF THE FEMORAL NECK
Authors: Smyth E. H. J. , Ellis J. S. , Manifold M. C. , Dewey P. R. 
Published: February 2018

1. A method of internal fixation of displaced subcapital fractures of the femoral neck is described, and a consecutive series of seventy-one patients whose fractures were treated by this method is reviewed. 2. It is claimed that this method gives better mechanical fixation than a trifin nail and that the operation is less formidable than the insertion of a pin and plate. 3. It is suggested that with improved fixation the avascular head can be supported while revascularisation occurs.
BLADDER PARALYSIS IN CAUDA EQUINA LESIONS FROM DISC PROLAPSE
Authors: Scott P. J. 
Published: February 2018

1. Ten patients with neurological evidence of damage to the intrathecal sacral nerve roots of the cauda equina by verified lumbar disc prolapse are described. 2. The nature of the bladder paralysis has been investigated by cystometry and the findings contrasted with published opinions. 3. The prognosis of the bladder paralysis has been established by review up to six years after removal of the disc prolapse. No evidence of recovery of complete bladder paralysis has been found, but the consequences of persistent bladder paralysis have been much less severe than previous reports have stated. Reasons have been suggested for this. 4. Principles of recognition and management of bladder paralysis due to cauda equina lesions have been stated and methods suggested.
PREMATURE EPIPHYSIAL FUSION AT THE KNEE COMPLICATING PROLONGED IMMOBILISATION FOR CONGENITAL DISLOCATION OF THE HIP
Authors: Botting T. D. J. , Scrase W. H. 
Published: February 2018

1. Three cases of premature epiphysial closure at the knee complicating prolonged immobilisation for congenital dislocation of the hip are described. 2. The etiology of this complication is briefly discussed, and it is suggested that relative ischaemia of the epiphysial plates is the most likely cause.
ON NECROSIS OF THE FEMORAL READ AFTER FRACTURE OF THE NECK OF THE FEMUR
Authors: Bohr H. , Larsen E. Hjalmar 
Published: February 2018

1. The development of sclerosis of the femoral head after fracture of the femoral neck has been investigated by a combined microradiographic and histological examination of twenty femoral heads removed during arthroplasty of the hip done at varying intervals after fracture. 2. Mineralisation of the bone did not differ from the normal. 3. There was a direct correlation between the density of the femoral head as judged radiologically and the width of the trabeculae. In cases of sclerosis of the femoral head the trabeculae were broader than normal and histological examination showed that this was caused by apposition of new bone upon the necrotic trabeculae. 4. Although sclerosis is a result of necrosis, it is at the same time a definite sign that revascularisation and restitution are going on.
OSTEOARTICULAR CHANGES IN A CASE OF ESSENTIAL OSTEOLYSIS
Authors: Lagier R. , Rutishauser E. 
Published: February 2018

1. A case of essential osteolysis is presented, occurring in a young man of eighteen with no known family history and developing progressively from early childhood. The condition was radiologically evident in the elbows, hands and feet, and was accompanied by atrophy of the cancellous bone of the epiphyses of the shoulders and knees. It was also associated with certain abnormalities of the skull and vertebrae. The patient died from a nephropathy of late onset. 2. Examination of the left foot revealed on the radiologically "lysed" bony extremities a very slow process of erosion affecting essentially the epiphysial and metaphysial cortical bone, of a non-inflammatory nature and accompanied by disappearance of the hyaline cartilage. The extremities not radiologically "lysed" showed signs of erosion that were histologically similar but not macroscopically evident; they were accompanied by regressive changes in the hyaline cartilage. 3. There were no signs of renal osteodystrophy or of Sudeck's dystrophy. 4. Post-mortem tests revealed an increase in the seromucoids and failed to reveal the presence of proline in the serum or of proline and hydroxyproline in the urine. 5. The authors discuss the place of this condition among osteolyses in general.
ABDUCTION CONTRACTURE OF THE SHOULDER FROM CONTRACTURE OF THE INTERMEDIATE PART OF THE DELTOID
Authors: Bhattacharyya S. 
Published: February 2018

1. Three cases of abduction contracture of the shoulder caused by fibrosis of the intermediate part of the deltoid muscle are described. 2. Treatment by removal of the affected part of the muscle was successful in each case. 3. Histological findings are described and the nature of the condition is discussed.
DUPUYTREN'S CONTRACTURE: AN AUTO-IMMUNE DISEASE?
Authors: Burch P. R. J. 
Published: February 2018

1. On the basis of, first, a mathematical analysis of the age-specific and sex-specific prevalence of Dupuytren's contracture; second, the genetical aspects; and last, the pathology, it is concluded that Dupuytren's contracture is probably a spontaneous disturbed-tolerance auto-immune disease. 2. The proportion of predisposed individuals at birth is about 20 per cent of males and females in the population studied by Early (1962), although it differs between populations and races. 3. The disease is probably initiated by four random, dependent-type, autosomal somatic gene mutations in a stem cell of the lymphoid system. With the accumulation of the fourth and final somatic mutation, a "forbidden-clone" of lymphocytes is probably generated. There is a latent period between the occurrence of the last initiating event and diagnosis. 4. In men the average latent period is about fifteen years, in women it is about thirty years. 5. The target tissue primarily attacked by forbidden lymphocytes is unknown, although proliferating fibroblasts are evidently a consequence of the auto-immune attack.
CORRECTION OF LEG LENGTH DISCREPANCY BY EPLPHYSIAL ARREST
Authors: Menelaus M. B. 
Published: February 2018

1. A simple calculation for the timing of epiphysial arrest to correct leg length discrepancy is described. An assumption is made that growth ceases at a constant chronological age of sixteen years in boys and fourteen years in girls. It is further assumed that the lower femoral epiphysis provides three-eighths of an inch and the upper tibial epiphysis one-quarter inch of growth each year. 2. Whilst the assumptions made are known to be approximations, analysis of the results of fifty-three epiphysial arrests in forty-four children shows that the errors cancel themselves sufficiently to make this method accurate. The simplicity of the calculation makes it useful to confirm or modify the timing of arrests calculated on the basis of skeletal age, or as an alternative method.
TRANSPOSITION OF LATISSIMUS DORSI FOR PARALYSIS OF TRICEPS BRACHII
Authors: du Toit G. T. , Levy S. J. 
Published: February 2018

1 . A case is described in which complete transposition of the latissimus dorsi muscle with its neurovascular pedicle was performed to compensate for complete paralysis of the triceps and partial paralysis of the posterior part of the deltoid muscle. 2. Muscle necrosis did not occur to any significant degree. 3. Strong substitute triceps function was achieved.
SOME OBSERVATIONS ON THE EFFECTS OF BLOOD AND A FIBRINOLYTIC ENZYME ON ARTICULAR CARTILAGE IN THE RABBIT
Authors: Guicciardi E. , Little K. 
Published: February 2018

1. In rabbit knees the effects of daily injections of saline, Varidase, blood, blood and Varidase simultaneously, and blood alternating with Varidase every third day have been compared. 2. Saline alone produces changes in joint cartilage comparable with a slight damage to the gel structure of the intercellular matrix. 3. The other four experiments resulted in changes in the articular cartilage comparable with the effects of a partial chemical degradation of the polysaccharide of the intercellular matrix. 4. Blood also induced hypertrophy of the synovial tissues. After the end of the injections healing of the cartilage was slower than with saline or with Varidase. 5. When blood and Varidase were given together the immediate effects were additive, but there was a considerable delay in healing.
NON-UNION AFTER INTERTROCHANTERIC OSTEOTOMY WITH INTERNAL FIXATION FOR OSTEOARTHRITIS OF THE HIP
Authors: Rosborough D. , Stiles P. J. 
Published: February 2018

1. One hundred and eight osteotomies were reviewed with regard to union, and fourteen were found to be ununited. In only one was non-union detected clinically; the others required radiographic demonstration. Tomographs were particularly helpful in confirming non-union. 2. Nine patients with non-union had pain, equal to or worse than before operation. The pain could not be distinguished from that of osteoarthritis of the hip. 3. Six of the patients with non-union needed an operation. Five had cancellous bone grafts followed by union in all except one. 4. The causes of non-union are reviewed. This complication was found to be less frequent in patients above sixty with stiff hips and bony collapse on the radiograph. Horizontal osteotomy with a displacement of not more than one-third of the diameter of the shaft reduced the incidence of non-union. The variable-angle nail-plate provided the best fixation. Traction provided no benefit and increased the incidence of non-union. Weight bearing is best avoided for eight weeks.