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DEVICE FOR REMOVING HEAD OF FEMUR
781 the strength of the individual patient, allows the hand and forearm to find an easy swinging position, and the pulley blocks allow a moderate range of movement in the shoulder to avoid it stiffening. In general the hand tends to swing about the level of the face but can be adjusted above or below this level by altering the length of the main suspension cord or the tension of the spring. The whole device is suspended from the end of a " monkey-pole ", which is standard equipment on most hospital beds. The materials for making this device are easily obtainable: most orthopaedic hospitals now have access to ’Plastazote ’, which is a moulded sheet of low-density expanded polyethylene ; the springs and pulleys are also obtainable in orthopaedic or physiotherapy departments. Messrs. Terry’s, of Redditch, supply a range of physiotherapy tension springs in various lengths and weights; springs of about fifteen to twenty pounds tension have been found suitable for supporting the arm splint. to
Fig. 1 illustrates the splint in use. Fig. 2 shows the assembly of the splint; in particular it may be noted that the height of the splint, and therefore the elevation of the hand and arm, may be adjusted by varying the point of suspension of the spring, or alternatively by adjusting the suspending cord underneath the elbow.
DEVICE FOR REMOVING HEAD OF FEMUR A. BECK Accident Unit, St. David’s
Hospital, Cardiff
IN operations for prosthetic replacement the head of the femur is usually removed by dislocating the head of the femur.1 If difficulties arise, even piecemeal removal may be required.2 I have
removing
successfully used a simple cork-screw for the of the head of the femur (see figure). This
Reviews of Books Gastro-intestinal A
X-ray Diagnosis
Descriptive Atlas.
F.F.R.
D. H. CUMMACK, M.B., F.R.C.S.E., R.C.S.I., D.M.R., consultant radiologist in administra-
tive charge, Western General Hospital, Edinburgh; member of clinical teaching staff, University of Edinburgh. Edinburgh: E. & S. Livinstone. Baltimore: Williams & Wilkins Co. Toronto: Macmillan Company of Canada. 1969. Pp. 344. E88 1Os.;$27.50.
THIS atlas is based on Dr. Cummack’s personal experithe Western General Hospital, Edinburgh, over the past 22 years. After the opening chapter, which deals with barium and ’Gastrografin’ meal examinations, the succeeding chapters follow more or less the anatomical divisions of the alimentary tract. Each section begins with a brief account of the radiological method of investigations, the normal appearances, and a short account of the main pathological lesions encountered. This is followed by a very extensive series of illustrations to elucidate the points described in the introduction. There are no references, beyond a few suggestions for further reading. The book’s great merit lies in the superb illustrationsabout 1000 clear reproductions of X-rays. Besides illustrating very fully a wide range of lesions commonly met with in the alimentary tract, many unusual lesions, including Crohn’s disease in the stomach and the duodenum, ulceration in the terminal ileum due to paratyphoid, and many other uncommon conditions are shown. There are some excellent pictures of a wide variety of abnormalities involving the small gut, most of which were proved by surgery or other methods. Other examples are shown where even after extensive investigation no firm diagnosis could be established. This book will be an invaluable addition to the library of any X-ray department. It will be in constant demand by radiologists in training, and even the most senior and experienced radiologists will be glad to have this delightful book to hand when presented with an odd or unusual appearance on barium studies. It is a fine achievement. ence at
International
Histological Classification of Tumours
Histological Typing of Soft Tissue Tumours. F. M. ENZINGER, in collaboration with R. LATTES and H. TORLONI. Geneva: World Health Organisation. 1969. Pp. 119. Obtainable from H.M. Stationery Office; the American Public Health Association Inc., 1740 Broadway, New York, N.Y. 10019; other W.H.O. sales agents; or from W.H.O. Distribution and Sales Unit, Geneva, Switzerland. £ 15;$50; Sw. fr. 150. MUCH of the material and many of the ideas put forward in this W.H.O. document emanate from the U.S. Armed
Femoral head removed by cork-screw after sub capital fracture in patient aged 85.
method has the following advantages: (a) the amount of dissection, of removal of capsular tissue, and of retraction is reduced; (b) the extraction is facilitated; and (c) if the head of the femur is turned in the acetabulum this can be easier corrected before the removal is carried out.
The cork-screw is best inserted near the cortex since the bone is harder in this area and gives a firmer grip. REFERENCES 1. 2.
Mercer, W., Duthie, R. E. Orthopaedic Surgery. London, 1964. Campbell’s Operative Orthopædics (edited by A. H. Crenshaw). Saint Louis, 1963.
Forces Institute of Pathology, where the principal author works. 520 tumours have been studied over several years there and at five other " collaborating centres " by ten other workers. The text is illustrated by 150 colour photomicrographs, and Dr. W. Mutschlechner of Geneva must be congratulated on their quality. The fields have been well chosen to bring out appearances stressed in the text. 152 good-quality colour transparencies are provided. British histopathologists may find them of less use than the photomicrographs; workers in other countries may be more used to this method of reproduction for private study. Compared with the previous two publications (lung and breast) the coverage is wide. Included are tumours of fibrous and adipose tissue, muscle, blood and lymph vessels, synovia, and mesothelial tissues. Tumours of peripheral nerves, sympathetic ganglia, and paraganglionic structures find a place " because the tumours of this group pose similar problems in diagnosis and treatment".
Fig. 1 illustrates the splint in use. Fig. 2 shows the assembly of the splint; in particular it may be noted that the height of the splint, and therefore the elevation of the hand and arm, may be adjusted by varying the point of suspension of the spring, or alternatively by adjusting the suspending cord underneath the elbow.
DEVICE FOR REMOVING HEAD OF FEMUR A. BECK Accident Unit, St. David’s
Hospital, Cardiff
IN operations for prosthetic replacement the head of the femur is usually removed by dislocating the head of the femur.1 If difficulties arise, even piecemeal removal may be required.2 I have
removing
successfully used a simple cork-screw for the of the head of the femur (see figure). This
Reviews of Books Gastro-intestinal A
X-ray Diagnosis
Descriptive Atlas.
F.F.R.
D. H. CUMMACK, M.B., F.R.C.S.E., R.C.S.I., D.M.R., consultant radiologist in administra-
tive charge, Western General Hospital, Edinburgh; member of clinical teaching staff, University of Edinburgh. Edinburgh: E. & S. Livinstone. Baltimore: Williams & Wilkins Co. Toronto: Macmillan Company of Canada. 1969. Pp. 344. E88 1Os.;$27.50.
THIS atlas is based on Dr. Cummack’s personal experithe Western General Hospital, Edinburgh, over the past 22 years. After the opening chapter, which deals with barium and ’Gastrografin’ meal examinations, the succeeding chapters follow more or less the anatomical divisions of the alimentary tract. Each section begins with a brief account of the radiological method of investigations, the normal appearances, and a short account of the main pathological lesions encountered. This is followed by a very extensive series of illustrations to elucidate the points described in the introduction. There are no references, beyond a few suggestions for further reading. The book’s great merit lies in the superb illustrationsabout 1000 clear reproductions of X-rays. Besides illustrating very fully a wide range of lesions commonly met with in the alimentary tract, many unusual lesions, including Crohn’s disease in the stomach and the duodenum, ulceration in the terminal ileum due to paratyphoid, and many other uncommon conditions are shown. There are some excellent pictures of a wide variety of abnormalities involving the small gut, most of which were proved by surgery or other methods. Other examples are shown where even after extensive investigation no firm diagnosis could be established. This book will be an invaluable addition to the library of any X-ray department. It will be in constant demand by radiologists in training, and even the most senior and experienced radiologists will be glad to have this delightful book to hand when presented with an odd or unusual appearance on barium studies. It is a fine achievement. ence at
International
Histological Classification of Tumours
Histological Typing of Soft Tissue Tumours. F. M. ENZINGER, in collaboration with R. LATTES and H. TORLONI. Geneva: World Health Organisation. 1969. Pp. 119. Obtainable from H.M. Stationery Office; the American Public Health Association Inc., 1740 Broadway, New York, N.Y. 10019; other W.H.O. sales agents; or from W.H.O. Distribution and Sales Unit, Geneva, Switzerland. £ 15;$50; Sw. fr. 150. MUCH of the material and many of the ideas put forward in this W.H.O. document emanate from the U.S. Armed
Femoral head removed by cork-screw after sub capital fracture in patient aged 85.
method has the following advantages: (a) the amount of dissection, of removal of capsular tissue, and of retraction is reduced; (b) the extraction is facilitated; and (c) if the head of the femur is turned in the acetabulum this can be easier corrected before the removal is carried out.
The cork-screw is best inserted near the cortex since the bone is harder in this area and gives a firmer grip. REFERENCES 1. 2.
Mercer, W., Duthie, R. E. Orthopaedic Surgery. London, 1964. Campbell’s Operative Orthopædics (edited by A. H. Crenshaw). Saint Louis, 1963.
Forces Institute of Pathology, where the principal author works. 520 tumours have been studied over several years there and at five other " collaborating centres " by ten other workers. The text is illustrated by 150 colour photomicrographs, and Dr. W. Mutschlechner of Geneva must be congratulated on their quality. The fields have been well chosen to bring out appearances stressed in the text. 152 good-quality colour transparencies are provided. British histopathologists may find them of less use than the photomicrographs; workers in other countries may be more used to this method of reproduction for private study. Compared with the previous two publications (lung and breast) the coverage is wide. Included are tumours of fibrous and adipose tissue, muscle, blood and lymph vessels, synovia, and mesothelial tissues. Tumours of peripheral nerves, sympathetic ganglia, and paraganglionic structures find a place " because the tumours of this group pose similar problems in diagnosis and treatment".