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Symposium on the applications of external power to artificial limbs and to splints
INTERNATIONAL
ABSTRACTS
OF PEDIATRIC
SUBTROCHANTERICOSTEOTOMY TREATMENT
OF
Axer. J. Bone Joint Surg. 1965.
IN
THE
DISEASE. A.
PERTHES’
(Brit.)
47B:489,
A preliminary report is given of 12 patients, 10 boys and 2 girls, ranging from 3 years to 11 years, treated by subtrochanteric osteotomy with derotation and varus correction after a preliminary manipulation and immobilization in plaster into full medial rotation and a degree of abduction sufficient to enclose the femoral epiphysis completely within the acetabulum, it being assumed that the maximum necrosis and deformity of the femoral head occurs in the anterolateral unsupported portion of the head. Unrestricted activity can be permitted 3 months after operation and the results seem to be no worse, if not much better, than those treated by- longer term, more concentrated and more restrictive methods. After operation no further deterioration in the anatomical shape of the hip joint was observed and improvement was the r&-F. H. Robarts INTRA-UTERINE LIMB
AMPUTATIONS
AND ANNULAR
DEFECTS IPITSINGAPORE. V.
lay and K. 7’. Hesketh. J. Surg. ( Brit. ) 47B: 514, 1965.
K. Pil-
Bone
Joint
This short report with representative and illustrative cases of these two types of abnormality reviews briefly the scope of these conditions and suggests etiologic factors (largely hypothetical) and some points in treatment. These conditions appear to be commoner in Malay than in many other parts of the world.-F.
H. Robarts
complete these
FANCY.
G.
Pilcher. 1965.
J.
IDIOPATHIC
Sco~10s1s
IN
IN-
Lloyd-Roberts and M. F. Bone Joint Surg. 478:520,
C.
Physical signs of convexity rib prominence and head rotational difficulty with concavity skin creases and radiologic evidence confirm the clinical diagnosis of structural idiopathic scoliosis in infancy. In 100 consecutive cases, 67 boys and 33 girls were recorded, the primary curve in all being thoracic-towards the left in 85 and to the right in 15, with a mean involvement of 7 vertebrae. Plagiocephaly was noted in 83. The average follow-up was for 3 years and spontaneous and
resolution
rapidly
and
occurred within
in 92, 78
a year
of
of
onset.
11 recovered slowly over 3 years and sometimes after initial deterioration. After full resolution none relapsed. In 3 the outcome is still in doubt after secondary curve formation, but in only 5 has there now developed an infantile idiopathic progressive scoliosis of bad prognosis-a condition which is established by the age of 2 years when all others are showing improvement.
Another
Time alone distinguishes the serious from the simple, and vertebral rotation in the x-ray is of sinister significance. It is suggested that fetal moulding may determine the condition. Skull moulding and rib cage moulding and even pelvic obliquity may be due to moulding, but the very definite sex ratio suggests other factors.-F. H. Robarts AN EVALUATIONOF AN EXTENSIVESPLINT FOR IDIOPATHICSTRUCTURAL SCOLIOSIS IN INFANCY. G. F. Walker. J. Snrg. ( Brit. ) 47B: 524, 1965.
Bone
Joint
The results of a series treated in the Denis Browne tray are given. Of 33 boys and 16 girls the curve was to the left in 31 and to the right in 18. Resolution occurred in 40, and 5 of the remaining 9 had progressive curves requiring treatment with Milwaukee braces. The conclusion is that the scoliosis tray does not increase the incidence of the resolution which can occur naturally.-F. H. Robarts TIBIALISSPASTICVANS FOOT WITH TARSAL COALITION.E. H. Simmons. J. Bone Joint Surg.
STRUCTURAL
109
SURGERY
47B:533,
1965.
Tarsal coalition-calcaneo-navicular bar malformation-is stressed as a cause of peroneal spastic flat foot. Three clinical cases are illustrative of the contention that a similar abnormality can also be associated with tibialis spastic varus foot and can be similarly relieved by early and adequate excision of the bar and interposition of soft tissues, usually the muscular origin of the extensor digitorum brevis.-F. H. Robarts SYMPOSIUMON THE APPLICATIONSOF ExTERNAL POWER TO ARTIFICIAL LIMBS AND TO SPLINTS.J. Bone Joint Surg. 47B: 399448, 1965.
ABSTRACTS
OF PEDIATRIC
SUBTROCHANTERICOSTEOTOMY TREATMENT
OF
Axer. J. Bone Joint Surg. 1965.
IN
THE
DISEASE. A.
PERTHES’
(Brit.)
47B:489,
A preliminary report is given of 12 patients, 10 boys and 2 girls, ranging from 3 years to 11 years, treated by subtrochanteric osteotomy with derotation and varus correction after a preliminary manipulation and immobilization in plaster into full medial rotation and a degree of abduction sufficient to enclose the femoral epiphysis completely within the acetabulum, it being assumed that the maximum necrosis and deformity of the femoral head occurs in the anterolateral unsupported portion of the head. Unrestricted activity can be permitted 3 months after operation and the results seem to be no worse, if not much better, than those treated by- longer term, more concentrated and more restrictive methods. After operation no further deterioration in the anatomical shape of the hip joint was observed and improvement was the r&-F. H. Robarts INTRA-UTERINE LIMB
AMPUTATIONS
AND ANNULAR
DEFECTS IPITSINGAPORE. V.
lay and K. 7’. Hesketh. J. Surg. ( Brit. ) 47B: 514, 1965.
K. Pil-
Bone
Joint
This short report with representative and illustrative cases of these two types of abnormality reviews briefly the scope of these conditions and suggests etiologic factors (largely hypothetical) and some points in treatment. These conditions appear to be commoner in Malay than in many other parts of the world.-F.
H. Robarts
complete these
FANCY.
G.
Pilcher. 1965.
J.
IDIOPATHIC
Sco~10s1s
IN
IN-
Lloyd-Roberts and M. F. Bone Joint Surg. 478:520,
C.
Physical signs of convexity rib prominence and head rotational difficulty with concavity skin creases and radiologic evidence confirm the clinical diagnosis of structural idiopathic scoliosis in infancy. In 100 consecutive cases, 67 boys and 33 girls were recorded, the primary curve in all being thoracic-towards the left in 85 and to the right in 15, with a mean involvement of 7 vertebrae. Plagiocephaly was noted in 83. The average follow-up was for 3 years and spontaneous and
resolution
rapidly
and
occurred within
in 92, 78
a year
of
of
onset.
11 recovered slowly over 3 years and sometimes after initial deterioration. After full resolution none relapsed. In 3 the outcome is still in doubt after secondary curve formation, but in only 5 has there now developed an infantile idiopathic progressive scoliosis of bad prognosis-a condition which is established by the age of 2 years when all others are showing improvement.
Another
Time alone distinguishes the serious from the simple, and vertebral rotation in the x-ray is of sinister significance. It is suggested that fetal moulding may determine the condition. Skull moulding and rib cage moulding and even pelvic obliquity may be due to moulding, but the very definite sex ratio suggests other factors.-F. H. Robarts AN EVALUATIONOF AN EXTENSIVESPLINT FOR IDIOPATHICSTRUCTURAL SCOLIOSIS IN INFANCY. G. F. Walker. J. Snrg. ( Brit. ) 47B: 524, 1965.
Bone
Joint
The results of a series treated in the Denis Browne tray are given. Of 33 boys and 16 girls the curve was to the left in 31 and to the right in 18. Resolution occurred in 40, and 5 of the remaining 9 had progressive curves requiring treatment with Milwaukee braces. The conclusion is that the scoliosis tray does not increase the incidence of the resolution which can occur naturally.-F. H. Robarts TIBIALISSPASTICVANS FOOT WITH TARSAL COALITION.E. H. Simmons. J. Bone Joint Surg.
STRUCTURAL
109
SURGERY
47B:533,
1965.
Tarsal coalition-calcaneo-navicular bar malformation-is stressed as a cause of peroneal spastic flat foot. Three clinical cases are illustrative of the contention that a similar abnormality can also be associated with tibialis spastic varus foot and can be similarly relieved by early and adequate excision of the bar and interposition of soft tissues, usually the muscular origin of the extensor digitorum brevis.-F. H. Robarts SYMPOSIUMON THE APPLICATIONSOF ExTERNAL POWER TO ARTIFICIAL LIMBS AND TO SPLINTS.J. Bone Joint Surg. 47B: 399448, 1965.