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DRILLING JIG FOR INTERTROCHANTERIC OSTEOTOMY OF FEMUR
360 evidence. Subjects such as a sentencing policy, the attitude of the police, possible revisions of the law, and the reform of the offender are discussed.
Teaching
the
Severely
Subnormal
Editor: E. B. McDowALL, M.B., D.SC., M.A., D.P.M., principal medical officer for mental health, Hampshire. London: Edward Arnold. 1964. Pp. 128. 20s.
THE work undertaken in the junior training centres is still little understood by most people whose main interest is the health and education of children. Many doctors, nurses, and teachers do not seem to know that teaching severely subnormal children does in fact take place in these centres. Such children attend these designated units (which are not given the dignity of being called schools, and which used to be called occupation centres) because their i.Q.s were found to be below 50. Many of them have had little home training, even training directed towards attaining personal independence, and almost none had been given the opportunity to handle any kind of play material until the dedicated teachers of the training centres came into their lives. This book is addressed to the staff of centres where these children may have had the good luck, through the cooperation of their medical officer of health with the medical officer of the education department of their local authority, to be placed at an early or even later age. It makes informative reading for the junior pxdiatrician, health visitor, and even for the general practitioner. The teacher of the very young, even when there is no doubt about the intellectual level, will find much of interest in the chapters on epilepsy, deafness, and problems of speech. Behaviour disturbances appear at any mental level, and the suggestions in these pages on the rational attitude to these upsets in children with a low I.Q. may prove helpful to any adult who meets the same antisocial activity in presumably normal children. The text is short and to the point. The appendix contains valuable advice on activity and special training measures. The references should be expanded in another edition; for they include first-hand experiences which are useful in the approach to a new subject, such as teaching the severely subnormal who, until recently, have been relegated to the unteachable.
St.
Mary’s Hospitals, Manchester, 1790-1963 J. H. YoL’NG, M.D., D.OBST., clinical tutor in obstetrics, Manchester University. Edinburgh: E. & S. Livingstone. 1964. Pp. 124. 30s.
THE reputation of these two hospitals, for the care of women and of children, is well known throughout the Western world, partly through the name of Charles White, one of the founders, but mainly through the work initiated in the 19th and early 20th centuries by Charles Clay on ovariotomy, Cullingworth on operations for infected fallopian tubes, and Donald and Fothergill on a plastic operation for uterine prolapse. These are all well described in the last chapter. The rest of this interesting and profusely illustrated book is concerned with the foundation in 1790, growth, and difficulties met at various times. It ends with an account of the splendid new midwifery block due to be built this year, which will at last unite the two hospitals. The story is compiled from old minute books and it is set against a most interesting social background. It will fascinate those who know the hospitals, but it should interest a much wider public. Better
Smoking (London: Allen
&
Unwin. 1964.
Pp.
85.
15...—This book, well translated from the Danish and illustrated by excellent and apposite photographs, is primarily for smokers whose minds are not closed to reason, yet to whom facts of chemistry. pathology, and pharmacology appeal more strongly than those of clinical medicine and everyday observation. It is also for those not prepared to abjure tobacco, but ready to alter their smoking habits if persuaded that it would be worth while. Though not directed to them, it should perhaps most of all be read by those in charge of children. Mr. Michael Schrøder presents clearly and simply facts drawn from many documented sources to support his views that " better smok-
"
would include not inhaling, a daily ration of 3-5 cigarettes, each after food or coffee and each smoked only down to a compulsorily printed half-way line, changing to small cigars, or giving up.
ing
The Medical Annual, 1964 (Bristol: John Wright. 1964. Pp. 552. 50s.).-In the 82nd edition Sir Ronald Bodley Scott and Prof. R. Milnes Walker follow the traditional pattern of the Annual. This year’s special articles include a discussion of the medical problems of air transport by Dr. A. Buchanan Barbour, an article on autoimmunity by Dr. Ian Mackay and Dr. Ian Wood, and a review of the management of acute retention of urine byMr. Ashton Miller.
New Inventions DRILLING JIG FOR INTERTROCHANTERIC OSTEOTOMY OF FEMUR To divide the femur in the intertrochanteric region for the operation of osteotomy, the use of power-driven oscillating saws is technically attractive, but the clean line of section may play some part in delaying osseous union. A similar criticism can be levelled at the use of the Gigli wire-saw. Division of the femur by means of multiple drill holes followed by an osteotome is free from these objections, but a large number of drill holes cannot be placed close together without some form of drilling jig. The instrument described here has proved very satisfactory. The jig is apto the lateral surface of the shaft of the femur at the level where the section is to be made. Through the centre hole of the jig a drill is passed in the estimated direction of the osteotomy. The handle is detached from the drill, and the drill remaining in the bone holds the jig in position against the femur. The direction of the drill can be checked on X-rays, or, alternatively, the operation can be performed under open vision, thus eliminating the need for X-ray control. The first drill is now tapped deeper into position so that it projects only slightly from the surface of the jig, and a long drill in a motor drill is used to pass through the holes remaining in the jig (fig. 1). The jig is then detached, the first drill is extracted, and the section is completed with an osteotome. The jig can be used for right or left hips and is marked to indicate that the handle of the jig is to be held towards the head of the patient; in this position the right or the left side is indicated by words engraved on the upper surface (fig. 2). The instrument is made for me by Charles Thackray & Co., Ltd., 10, Park Street, Leeds, 1. Centre for Hip Surgery, JOHN CHARNLEY Wrightington Hospital,
plied
Wigan, Lancs
M.B.,
D.SC.
Manc.,
F.R.C.S.
Teaching
the
Severely
Subnormal
Editor: E. B. McDowALL, M.B., D.SC., M.A., D.P.M., principal medical officer for mental health, Hampshire. London: Edward Arnold. 1964. Pp. 128. 20s.
THE work undertaken in the junior training centres is still little understood by most people whose main interest is the health and education of children. Many doctors, nurses, and teachers do not seem to know that teaching severely subnormal children does in fact take place in these centres. Such children attend these designated units (which are not given the dignity of being called schools, and which used to be called occupation centres) because their i.Q.s were found to be below 50. Many of them have had little home training, even training directed towards attaining personal independence, and almost none had been given the opportunity to handle any kind of play material until the dedicated teachers of the training centres came into their lives. This book is addressed to the staff of centres where these children may have had the good luck, through the cooperation of their medical officer of health with the medical officer of the education department of their local authority, to be placed at an early or even later age. It makes informative reading for the junior pxdiatrician, health visitor, and even for the general practitioner. The teacher of the very young, even when there is no doubt about the intellectual level, will find much of interest in the chapters on epilepsy, deafness, and problems of speech. Behaviour disturbances appear at any mental level, and the suggestions in these pages on the rational attitude to these upsets in children with a low I.Q. may prove helpful to any adult who meets the same antisocial activity in presumably normal children. The text is short and to the point. The appendix contains valuable advice on activity and special training measures. The references should be expanded in another edition; for they include first-hand experiences which are useful in the approach to a new subject, such as teaching the severely subnormal who, until recently, have been relegated to the unteachable.
St.
Mary’s Hospitals, Manchester, 1790-1963 J. H. YoL’NG, M.D., D.OBST., clinical tutor in obstetrics, Manchester University. Edinburgh: E. & S. Livingstone. 1964. Pp. 124. 30s.
THE reputation of these two hospitals, for the care of women and of children, is well known throughout the Western world, partly through the name of Charles White, one of the founders, but mainly through the work initiated in the 19th and early 20th centuries by Charles Clay on ovariotomy, Cullingworth on operations for infected fallopian tubes, and Donald and Fothergill on a plastic operation for uterine prolapse. These are all well described in the last chapter. The rest of this interesting and profusely illustrated book is concerned with the foundation in 1790, growth, and difficulties met at various times. It ends with an account of the splendid new midwifery block due to be built this year, which will at last unite the two hospitals. The story is compiled from old minute books and it is set against a most interesting social background. It will fascinate those who know the hospitals, but it should interest a much wider public. Better
Smoking (London: Allen
&
Unwin. 1964.
Pp.
85.
15...—This book, well translated from the Danish and illustrated by excellent and apposite photographs, is primarily for smokers whose minds are not closed to reason, yet to whom facts of chemistry. pathology, and pharmacology appeal more strongly than those of clinical medicine and everyday observation. It is also for those not prepared to abjure tobacco, but ready to alter their smoking habits if persuaded that it would be worth while. Though not directed to them, it should perhaps most of all be read by those in charge of children. Mr. Michael Schrøder presents clearly and simply facts drawn from many documented sources to support his views that " better smok-
"
would include not inhaling, a daily ration of 3-5 cigarettes, each after food or coffee and each smoked only down to a compulsorily printed half-way line, changing to small cigars, or giving up.
ing
The Medical Annual, 1964 (Bristol: John Wright. 1964. Pp. 552. 50s.).-In the 82nd edition Sir Ronald Bodley Scott and Prof. R. Milnes Walker follow the traditional pattern of the Annual. This year’s special articles include a discussion of the medical problems of air transport by Dr. A. Buchanan Barbour, an article on autoimmunity by Dr. Ian Mackay and Dr. Ian Wood, and a review of the management of acute retention of urine byMr. Ashton Miller.
New Inventions DRILLING JIG FOR INTERTROCHANTERIC OSTEOTOMY OF FEMUR To divide the femur in the intertrochanteric region for the operation of osteotomy, the use of power-driven oscillating saws is technically attractive, but the clean line of section may play some part in delaying osseous union. A similar criticism can be levelled at the use of the Gigli wire-saw. Division of the femur by means of multiple drill holes followed by an osteotome is free from these objections, but a large number of drill holes cannot be placed close together without some form of drilling jig. The instrument described here has proved very satisfactory. The jig is apto the lateral surface of the shaft of the femur at the level where the section is to be made. Through the centre hole of the jig a drill is passed in the estimated direction of the osteotomy. The handle is detached from the drill, and the drill remaining in the bone holds the jig in position against the femur. The direction of the drill can be checked on X-rays, or, alternatively, the operation can be performed under open vision, thus eliminating the need for X-ray control. The first drill is now tapped deeper into position so that it projects only slightly from the surface of the jig, and a long drill in a motor drill is used to pass through the holes remaining in the jig (fig. 1). The jig is then detached, the first drill is extracted, and the section is completed with an osteotome. The jig can be used for right or left hips and is marked to indicate that the handle of the jig is to be held towards the head of the patient; in this position the right or the left side is indicated by words engraved on the upper surface (fig. 2). The instrument is made for me by Charles Thackray & Co., Ltd., 10, Park Street, Leeds, 1. Centre for Hip Surgery, JOHN CHARNLEY Wrightington Hospital,
plied
Wigan, Lancs
M.B.,
D.SC.
Manc.,
F.R.C.S.