bluuebunny/crossref_metadata_2025_split huggingface dataset:
TUBERCULOSIS OF THE SPINE
Authors: Dobson J. 
Published: February 2018

1. Nine hundred and fourteen cases of tuberculosis of the spine are analysed and the late results ascertained three or more years after discharge from hospital. 2. The relative frequency with which the various segments of the spine are involved has been found. Cervical disease was present in 3Â·5 per cent of cases, thoracic in 43Â·l per cent, lumbar in 32Â·9 per cent, thoraco-lumbar in 16Â· 7 per cent and lumbo-sacral in 3Â·8 per cent. 3. The mortality rate was 16Â·7 per cent. In patients with multiple lesions 25Â·5 per cent died, compared with 12Â·3 per cent in the group without complications. When chronic secondarily infected abscesses and sinuses were present the mortality rate was 19Â·1 per cent, and of patients with paraplegia 24Â·8 per cent died. 4. In the late results the working capacity of 390 patients was ascertained. It was full in 86 per cent, partial in 5Â·8 per cent and nil in 8Â·2 per cent. 5. An attempt has been made to determine the site of the primary bone focus from the radiograph. Early "epiphysial" changes were present in 33 per cent ; the central focus beginning in the spongy tissue of a vertebral body was present in 11Â·6 per cent; subperiosteal lesions were present in 2Â·1 per cent; and infection of the neural arch was present in only 0Â·5 per cent. In 52Â·8 per cent, however, widespread destruction had taken place when the patient first came under observation. 6. The ill effect of complications upon the prognosis is stressedâespecially in the cases of multiple foci of active tuberculosis, secondarily infected abscesses and sinuses, and paraplegia. Paraplegia occurred in 31Â·2 per cent of the cases of thoracic disease. 7. An attempt has been made to determine the frequency with which tuberculosis of the spine heals by spontaneous bony fusion of the affected vertebral bodies. It was found in 27Â·3 per cent of the cases in the present series. 8. Reasons for further treatment after the initial discharge of the patient are examined.
THE TREATMENT OF CLAW TOES BY MULTIPLE TRANSFERS OF FLEXOR INTO EXTENSOR TENDONS
Authors: Taylor R. G. 
Published: February 2018

1 . The principles and technique of flexor-extensor tendon transfers for claw toes are described. The operation is tedious, but it is effective in selected cases. 2. Sixty-eight patients have been operated upon and followed up; good results were obtained in fifty, fair results in eleven, and poor in seven. More careful selection and better operative technique might have avoided some of the failures. 3. The operation restores useful function to the toes at the cost of their prehensile action, diminishes any cavus deformity of the foot, and, by lessening the prominence of the metatarsal heads in the sole, avoids callosities and discomfort.
TRANSFER OF THE TIBIALIS ANTERIOR TENDON FOR RELAPSED CLUB-FOOT
Authors: Critchley J. E. , Taylor R. G. 
Published: February 2018

1 . Twenty-two cases of transplantation of the tibialis anterior for relapsed club-foot have been reviewed. Results were good in sixteen cases, fair in two and bad in four. 2. The operation and routine treatment are described. 3. The reasons for the four failures are discussed. 4. It is concluded that the operation is well worth while, and will often avoid the need for bony stabilisation at a later date.
FLAKE FRACTURE OF THE TALUS PROGRESSING TO OSTEOCHONDRITIS DISSECANS
Authors: Marks Kenneth L. 
Published: February 2018

1. A case of flake fracture of the talus progressing to osteochondritis dissecans is reported. 2. The relationship between direct injury and the onset of the lesion is noted. 3. The sequence of events was observed radiographically and clinically for two years from the date of the original injury.
DEFORMITY OF THE ELBOW JOINT AS A SEQUEL TO ERB'S OBSTETRICAL PARALYSIS
Authors: Aitken John 
Published: February 2018

1. In a survey of 107 cases of Erb's paralysis, twenty-seven instances of incipient or actual posterior dislocation of the upper end of the radius were discovered. 2. The type of case in which the dislocation occurs is defined and the early clinical and radiographic signs of the displacement are described and illustrated. 3. The probable causesâmuscle imbalance and rigid splinting over a long periodâare adumbrated and the prevention and remedies are suggested. 4. The occurrence of anterior dislocationâsix casesâand its significance are discussed.
HAEMOPHILIAC ARTHROPATHY OF THE HIP
Authors: Winston M. E. 
Published: February 2018

1. Seven cases of haemophiliac arthropathy of the hip joint are reported. 2. Attention is drawn to the different appearances in the hip when it is affected before and after puberty. Before puberty there are features similar to pseudocoxalgia. After puberty there may be cyst formation, coxa valga, or features similar to osteoarthritis. 3. It is suggested that intra-osseous haemorrhage is important in the production of these changes and that intra-epiphysial haemorrhage is responsible for the appearances seen before puberty.
SOME OBSERVATIONS ON VENOUS PRESSURE ESTIMATIONS IN THE LOWER LIMB
Authors: Boyd A. M. , Catchpole B. N. , Jepson R. P. , Rose S. S. 
Published: February 2018

1 . A technique for measuring venous pressure during exercise is described. 2. The findings in normal and abnormal conditions of the lower limb are recorded. 3. The mechanisms involved in the return of blood from the lower limb in various conditions are discussed, with particular reference to the post-phlebitic state. 4. The need for an objective method of assessing the results of surgical treatment of venous abnormalities in the lower limb is stressed.
ELMSLIE'S OPERATION FOR THE CALCANEUS FOOT
Authors: Cholmeley J. A. 
Published: February 2018

1 . Paralytic talipes calcaneus and calcaneo-cavus are difficult deformities to correct and keep corrected. Many operations have been devised for this purpose. 2. Emslie's operation is a simple procedure by which satisfactory correction can be obtained and maintained. It can be modified to suit individual cases without altering the basic principles of the procedure and is physiologically sound. 3. Illustrative cases are described.
THE NORMAL VASCULAR ANATOMY OF THE FEMORAL HEAD IN ADULT MAN
Authors: Trueta J. , Harrison M. H. M. 
Published: February 2018

1. The form and distribution of the blood vessels within the adult human femoral head are described. 2. It has been found possible to delimit the proximal femoral epiphysis in mature years by reference to arterial form alone. 3. Two morphologically different sets of vessels are described interposed between the arterioles and venules of the bone marrow. One, a true capillary bed, lies mainly within the fat marrow; the other, constituted by sinusoids, lies within the red marrow. The departure of these findings from current views is noted. 4. A capillary system is described in relationship to the calcified zone of the articular cartilage. 5. No evidence has been found in support of the common belief that the circulation within the femoral head decreases quantitatively with advancing age.
NUCLEAR HERNIATIONS OF THE INTERVERTEBRAL DISC
Authors: Begg A. C. 
Published: February 2018

1. As a result of degenerative changes in the intervertebral disc, nuclear tissue often herniates through its confining structures. These lesions are common, even in children, and often lead to difficulty in diagnosis. 2. The radiological manifestations of nuclear herniations into the spongiosa of the vertebral body, through the anterior part of the annulus fibrosus, beneath the epiphysial ring, and through the posterior part of the annulus are described and illustrated. The clinical significance of these radiological appearances and their pathological basis is indicated. 3. An understanding of the significance of the radiological findings in herniation of the nucleus pulposus and a careful correlation with the clinical features of the case are necessary for accurate diagnosis.
THE NATURAL HISTORY OF OSTEOID OSTEOMA
Authors: Golding J. S. R. 
Published: February 2018

1. The clinical features in twenty cases of osteoid osteoma have been analysed and compared with other cases reported in the literature. 2. The lesion is regarded as a benign neoplasm and its unusual clinical behaviour is attributed to its vascular nature. 3. The frequency with which an erroneous diagnosis of "neurosis" is made is stressed.
PARALYTIC DISLOCATION OF THE HIP
Authors: Jones G. Blundell 
Published: February 2018

1. Twenty-two dislocations of the hip occurring in patients paralysed from an early age have been studied. All showed abnormal coxa valga. The coxa valga, which may gradually reach 180 degrees, precedes dislocation and makes it inevitable. The presence of unbalanced adductor power may hasten dislocation, but the latter can occur in complete flaccid paralysis. 2. The combination of structural instability of the hip joint and muscular weakness may make independent walking impossible, but restoration of stability gives considerable improvement in any remaining muscular power and may alter the patient's whole future. 3. A method of correcting the basic deformity of coxa valga by osteotomy is described and the results of nine operations are reviewed.
HISTOCHEMICAL STUDIES OF BONE IN NORMAL AND PATHOLOGICAL CONDITIONS
Authors: Schajowicz Fritz , Cabrini Romulo L. 
Published: February 2018

1. Histochemical studies have been made of the distribution of alkaline phosphatase, glycogen and acid mucopolysaccharides in normal growing bones (mice, rats and men) and also in forty cases of pathological bone processes (neoplastic and dystrophic). 2. The study of normal material confirmed that alkaline phosphatase is plentiful in calcification of cartilage and even more plentiful in bone formation (whether enchondral or direct). 3. It was observed that glycogen increased in the cartilage areas about to be calcified, and that it disappeared in those calcified. It seemed that osteoblasts did not always contain glycogen. 4. In the pathological material (tumours and dystrophic processes) there was great phosphatase activity in the osteogenic areas and also in the cartilage about to be calcified. Whereas glycogen was plentiful in some cases of neoplastic or reactive osteogenesis, it was absent from others. 5. In every area of normal or pathological ossification, the presence of phosphatase seems to be a rule; glycogen is often but not always present. 6. It appears that alkaline phosphatase plays an important role in the formation of the protein matrix of bone, but is not associated with the elaboration of the mucoprotein cartilage matrix. We believe it is premature to draw any definite conclusion on the behaviour and role of the metachromatic substances in the processes of calcification and ossification. The histochemical study of alkaline phosphatase has shown that this is a valuable method in the detection of reactionary or pathological osteogenic processes which in some cases are difficult to demonstrate with the usual histological methods.
OSTEOMYELITIS IN THE NEW-BORN
Authors: Potter C. M. C. 
Published: February 2018

1. Recent published reports of neonatal osteomyelitis in long bones are reviewed. 2. Six further cases are described. 3. The source of infection is usually the skin or the umbilicus, and the common organisms are the haemolytic streptococcus and staphylococcus aureus. 4. Cases fall into two groups: in one the patient is acutely ill with septicaemia and the bone lesion is of secondary importance; in the other the general condition is well maintained even though there may be multiple bone lesions. 5. Sequestration is uncommon; but when it occurs it prevents the rapid healing that is usually observed after drainage. 6. The most important complication is suppurative arthritis, which may lead to total destruction of a joint. 7. It is probable that the lowered mortality from infantile septicaemia will be matched by a corresponding increase in the cases of acute osteomyelitis encountered in clinical practice.
FANCONI'S SYNDROME
Authors: Singer Martin 
Published: February 2018

1. A case of Fanconi's syndrome, with evidence of renal tubular dysfunction, is reported. 2. Healing of the rachitic lesions followed massive doses of calciferol. There was simultaneous improvement in the biochemical state. This case is probably unique in that the amino-aciduria disappeared. 3. Two-stage osteotomies were undertaken for the correction of severe bowing of the tibiae. 4. No toxic symptoms have developed so far from the calciferol therapy.
THE NATURAL HISTORY OF PLEURAL EFFUSION AND ORTHOPAEDIC TUBERCULOSIS
Authors: Stevenson F. Harwood 
Published: February 2018

1. Details are given of sixty-three consecutive cases with a history of pleural effusion seen at an orthopaedic hospital. 2. Twenty-four of these were post-primary effusions occurring before the onset of symptoms of the orthopaedic lesion. The bone and joint lesions ultimately developing in this group of patients were widely scattered throughout the skeleton. 3. Three others were secondary to adult-type pulmonary lesions. 4. Thirty-six patients had a pleural effusion after the beginning of their orthopaedic tuberculous history. Seven were certainly secondary to operative intervention, six in the thorax near the parietal pleura (costotransversectomy or antero-lateral decompression of the cord) and one from a haematogenous dissemination after fusion of a hip joint. 5. The remainder of this group with pleural effusion during the history of their orthopaedic tuberculous disease numbered twenty-nine. Of these, twenty-five suffered from disease of the thoracic spine; in two more details are defective. Only two definitely had neither pulmonary nor thoracic spinal disease; their lesions were in the lumbar spine. The conclusion is drawn that the overwhelmingly common cause of pleural effusion in patients with orthopaedic tuberculosis who have normal lungs and have not recently suffered spinal decompression is transpleural infection from thoracic spinal disease and that the sequence is by no means rare. It had occurred in approximately one in six of 145 patients with thoracic Pott's disease seen during this investigation. 6. Details are given of a group of cases with thoracic paravertebral abscess tracking laterally. When the abscess is well clear of the spine and spinal ligaments it may project forwards and radiologically it may appear in the antero-posterior chest film as a shadow in the middle of one or other lung field rather than as a shadow obviously connected with the central paravertebral abscess. Aspiration will yield pus from this posterior extra-pleural abscess extension. 7. The belief that Pott's disease most commonly follows direct spread from caseous paraaortic glands secondary to tuberculous pleurisy is discussed. It is concluded that the evidence is insufficient for so sweeping a statement.
THE SURGICAL TREATMENT OF TARSO-METATARSAL FRACTURE-DISLOCATIONS
Authors: del Sel Jose Manuel 
Published: February 2018

1. In the treatment of tarso-metatarsal fracture-dislocations open reduction is advocated whenever closed reduction is found impossible. 2. A technique of operation is described whereby, after reduction, temporary transfixion wires are used to prevent redisplacement.
LUMBO-SACRAL ARTHRODESIS AFTER LAMINECTOMY
Authors: Adkins E. W. O. 
Published: February 2018

1. The usual methods of posterior arthrodesis of the lumbo-sacral joint are not satisfactory in cases in which laminectomy has been performed. 2. Estimation of fusion by mobility radiographs is unreliable and cannot distinguish between fibrous ankylosis and bony fusion. 3. Bone grafts inserted from behind between the vertebral bodies almost invariably fail to become incorporated. 4. Intertransverse arthrodesis has given promising results and is probably the best method available at present.
DEPOSITION OF CALCIUM SALTS IN THE POPLITEUS TENDON
Authors: Holden N. T. 
Published: February 2018

1. Two cases of deposition of calcium on the outer side of the knee are described. 2. The condition is believed to be uncommon and does not appear to have been described before. 3. One case resolved with conservative treatment, the other after an operation at which the deposit was found in the tendon of popliteus.
THE FANCONI SYNDROME
Authors: Saville Paul D. , Nassim R. , Stevenson F. Harwood , Mulligan Lily , Carey Margaret 
Published: February 2018

1. Metabolic balance studies in two cases of the Fanconi syndrome are presented. 2. The actions of sodium bicarbonate and calciferol on the calcium and phosphorus balance were observed separately in the two cases. 3. The results show that sodium bicarbonate alone corrects acidosis and decreases the loss of calcium in the urine. 4. Calciferol in high dosage will increase intestinal absorption of calcium and phosphorus, but the urine calcium excretion then increases and vitamin D alone does not, therefore, give a positive balance adequate for complete healing and normal growth. 5. Alkalies and calciferol together put these cases into strongly positive calcium and phosphorus balance and promote healing of rickets, osteomalacia and pseudo-fractures. 6. Large doses of sodium bicarbonate in tablet form correct acidosis, do not adversely affect intestinal absorption of calcium, and facilitate accurate dosage and convenient administration. 7. Alkali therapy may lower serum potassium and precipitate symptoms of hypokalaemia in potassium-losing patients. This is thought to have been the cause of symptoms in several cases reported in the literature.
DISPLACEMENT OSTEOTOMY OF THE UPPER END OF THE FEMUR
Authors: Wardle E. N. 
Published: February 2018

1. Forty patients out of sixty-nine operated upon between 1932 and 1952 by displacement osteotomy for congenital dislocation of the hip, ununited fracture of the neck of the femur, and osteoarthritis of the hip have been reviewed and the results analysed. 2. The factors responsible for the success of the operation are discussed and the technique of operation is described.
SACRAL EXTRADURAL CYST: AN UNCOMMON CAUSE OF LOW BACK PAIN
Authors: Schurr Peter H. 
Published: February 2018

1. A case of low back pain due to a sacral extradural cyst is reported. Radiographs of the sacrum showed an ovoid expansion of the sacral canal. Myelography and exploratory laminectomy revealed an extradural cyst associated with a defect in the dural root sleeve surrounding the second left sacral roots. Relief of symptoms followed evacuation of the cyst and repair of the defect. 2. The differential diagnosis of the condition, the varieties of extradural cyst, and the features which distinguish them from perineurial cysts are described.
ORTHOPAEDIC PROBLEMS OF HEREDITARY SENSORY NEUROPATHY
Authors: Heller Leon , Heller Irving H. , Petrie J. G. 
Published: February 2018

1. Three cases of hereditary sensory neuropathy are reported. 2. Neuropathic destruction of joints and chronic infected ulcers are the primary problems of management. 3. This entity must be considered in the differential diagnosis of trophic ulcerations of the extremities.
THE CYSTS OF OSTEOARTHRITIS OF THE HIP
Authors: Rhaney K. , Lamb D. W. 
Published: February 2018

1. An attempt has been made to correlate the radiographic appearances and the morbid anatomy of the cystic changes that occur in the head of the femur in advanced osteoarthritis. 2. The suggestion is made that these lesions are foci of traumatic bone necrosis. Repair may be complicated by the subsequent entrance of synovial fluid through defects in the surface.
THE SIGNIFICANCE OF METALLIC TRANSFER IN ORTHOPAEDIC SURGERY
Authors: Bowden F. P. , Williamson J. B. P. , Laing P. G. 
Published: February 2018

1. Experiments using radio-isotope techniques show that whenever an orthopaedic appliance is inserted into the body tiny fragments of the instruments used to handle it become detached and welded on to the surface of the buried metal. 2. There is evidence that these particles of non-passive tool-metal may cause a small but continuing dissolution of the stainless metal to which they are attached, and that this dissolution, although too small to be detected as visible corrosion, may produce an adverse tissue reaction. 3. In samples of human tissue taken from sites adjacent to buried metal the greatest level of tissue reaction and the highest concentration of iron were found near those parts of the appliances that had been handled with the tools and received the greatest amount of transferred metal. 4. Spectroscopic analyses of similar samples confirmed that the concentration of metal in the tissues surrounding a buried appliance correlates closely with the distribution on its surface of transferred tool metal. Particularly high concentrations of chromium, nickel, and cobalt were found near regions where the transfer had been heavy. The dissolution was not limited to the non-passive foreign metal; the stainless appliance was also dissolved in those regions. 5. The influence of the manner of handling the tools on the amount and distribution of transfer has been studied, and suggestions are made whereby the transfer might be reduced.
HEREDITARY FORMS OF RICKETS AND OSTEOMALACIA
Authors: Dent C. E. , Harris H. 
Published: February 2018

1. We have described here various forms of rickets and osteomalacia that we have studied ourselves and have come to recognise as comprising definite syndromes. We have included only diseases in which hereditary factors have been proved or might be suspected to play a part. 2. There are more of these syndromes than previously defined. 3. All these hereditary diseases can be treated, usually very satisfactorily, using the same general principles and with only very few simple medicines such as vitamin D and sodium bicarbonate. Careful control and long follow-up, however, may be required to achieve best results and to avoid accidents. 4. A study of the genetics of the diseases is a help in diagnosis and treatment. Broadly speaking the group of diseases which mimic vitamin D deficiency more or less closely tend to be inherited in dominant fashion. The groups with more severe degree of renal-tubule abnormality are inherited as recessives. 5. When more than one member of a family is affected it has been found that in each family each syndrome runs true to type.
CHONDROMALACIA OF THE PATELLA
Authors: Wiles Philip , Andrews P. S. , Devas M. B. 
Published: February 2018

1. Chondromalacia, sometimes a precursor of osteoarthritis, is present in the articular cartilage of the patella of most people by the age of thirty; it causes symptoms in only a few, and it gives rise to osteoarthritis in fewer still. It may progress slowly or quickly but there is no clinical method of assessing the prognosis at an early stage. 2. The earliest change is swelling of the cartilage associated with a decrease in the chondroitin sulphuric acid content of the matrix. Later the cartilage fissures and flakes off to expose the bone, and there are reactive changes in the cartilage, bone and synovial membrane. The process is described and the etiology discussed. 3. The symptoms, signs and treatment are discussed. Operation, which has been performed only when there are disabling symptoms, may consist in removing part or the whole of the articular cartilage, or in excision of the patella. The results in forty-six knees are given.
THE VALUE OF RIGID FIXATION IN THE TREATMENT OF FRACTURES OF THE ADULT TIBIAL SHAFT
Authors: Blockey N. J. 
Published: February 2018

1. The thesis is advanced that in the treatment of fractures of the adult tibia rigid fixation is desirable. 2. The mechanical factors are discussed and a technique is described which provides a high degree of fixation without exposing more than one surface of the bone. 3. The process of healing of such fractures is described and the results in thirty-three unselected patients are given.