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Football injuries in the very young athlete
692 FRACTURE OF NECK AND SHAFT OF SAME FEMUR: REPORT OF A CASE IN A CHILD. D. F. Fardon. J. Bone Joint Surg. 52A: 797-799 (June), 1970. A case of the rare combination of a fracture of the ipsilateral femoral neck and shaft fracture is reported with the neck fracture surgically treated and the shaft fracture treated with traction.--Anhony H. Alter. TEAR OF THE ATTACHMENT OF A NORMAL MEDIAL MENISCUS OF THE KNEE IN A FOUR YEAR OLD CHILD. N. D. Saddawi and B. K. HofJman. J. Bone Joint Surg. 52A:809-811 (June), 1970. This is the first known case report of a 4-year-old with a tear of an otherwise normal meniscus, proved at surgery.--Anthony H. Alter. THE INTRA-ARTICULAR DEFORMITY IN OSTEOCHONDRITIS DEFORMANS, TIBIA. R-S Siffert and J. F. Katz. J. Bone Joint Surg. 52A:800-804 (June), 1970. Five children with tibia vara had exploratory knee arthrotomies at the time of their corrective tibial osteotomies. A central depression of the postero-medial tibial plateau was always found, which gives a clearer explanation for the clinical picture of bowing, tibial torsion, a varus knee and posteromedial instability.---Anthony H. Alter. NECROSIS OF ARTICULAR CARTILAGE AFTER SLIPPING OF THE CAPITAL FEMORAL EPIPHYSIS: REPORT OF SIX CASES WITH RECOVERY. H. G. Lowe. J. Bone Joint Surg. 52B: 108-117 ( F e b r u a r y ) , 1970. Previous reports of capital femoral epiphysis cartilage necrosis after epiphysiolysis have been associated with poor results. The six patients reported have good asymptomatic function, with longest follow-up at 15 years, but all have restriction of motion and narrowing of the joint space in X ray, foretelling future serious p r o b l e m s . - - A n t h o n y H. Alter. A SCOLIOSIS-PREVALENCE SURVEY IN MINNESOTA. W. J. Kane and J. H. Moe. Clin. Orth. 69:216-218 (March-April), 1970. A review of 75,290 live births in 1950 in Minnesota found a rate of 0.133 per cent
ABSTRACTS incidence of scoliosis. This series consisted of 100 patients with 72 idiopathic curves, 10 congenital spinal deformations and 13 due to polio. There was a 5:1 female prepondera n c e . - - A n t h o n y H. Alter. THE INCIDENCE AND TREATMENT OF SCOLIOSIS IN CEREBRAL PALSY. G. A. Balmer and G. D. MacEwen. J. Bone Joint Surg. 52B: 134-137 ( F e b r u a r y ) , 1970. Twenty-one patients in 100 children with cerebral palsy had scoliosis of more than 10 degrees. Ten required surgery consisting of fusion with Harrington instrumentation, which was able to create a stable compensated spine.--Anthony H. Alter. ACUTE OSTEOMYELITIS IN CHILDREN. N. J. Blockley and J. T. Watson. J. Bone Joint Surg. 52B:77-87 (February), 1970. 113 patients with osteomyelitis over a 9year-period were reviewed. The most commonly cultured organism was staphylococcus aureus in 68 cases, resistant to penicillin in 49. The best results were obtained with antibiotic therapy for 3-12 weeks. Surgery was performed early in the series with little contribution to improvement. 21 cases failed to respond to antibiotics, including 13 patients who had surgery. Extensive bone involvement prior to onset of therapy resulted in the poorest prognosis for cure. A n elevated sedimentation rate was of some value in documenting persistent infection. Clinical assessment of bone tenderness was the other useful diagnostic t e s t . - - A n t h o n y H. Alter. FOOTBALL INJURIES IN THE VERY YOUNG ATHLETE. L. A. Roser and D. K. Clawson. Clin. Orth. 69:219-223 (March-April), 1970. The authors reviewed 2079 players participating in football leagues, separated by age and weight, in Seattle, Wash. There were a total of 48 football related injuries, fairly evenly distributed in all ages. Seventeen ( 3 5 % ) injuries were fractures, 17 sprains and strains with contusions, and eleven lacerations; two concussions and one dislocation comprising the rest. Injuries were more frequent in first string players who also had had more previous experience at football. Thirtythree of the injuries occurred in practice. The hand, knee, wrist, ankle and thorax sus-
ABSTRACTS
tained most of the injuries. A comparison of statistical data for children's injuries show football in Seattle to have less injuries than children get in day-to-day living.--Anthony H. Alter.
NERVOUS SYSTEM GAMMA-CISTERNOGRAPHY IN INFANTS AND
CHILDREN. R. Oberson. Schweiz. Med. Wschr. 100:867-874, 1970. Cisternography with 100 #Ci iodated serum-albumin was performed in 15 normal children and 34 pathological cases, in the age group of 2 months to 15 years. In the normal, movement and absorption of CSF are very rapid. Data obtained from pathological cases are manifold: (1) In the case of diffusely reduced leptomeningeal pericerebral permeability or local circulatory impairment at important crossroads such as incisural notch or optochiasmatic cistern, either constant or transitory ventricular contamination may be observed. This apparently reversed flow of CSF could be accounted for by an increased or newly developed absorptive function of the ependyme, and this phenomenon constitutes the main indication for surgical treatment of hydrocephalus. (2) If leptomeningeal permeability is only slightly and/or diffusely impaired, the bulk flow of CSF, i.e., absorption of some of its constituents, appears to be slowed. In this situation the patient should be followed at monthly intervals, in order not to miss the opportunity of surgical correction. (3) Absence of any apparent bulk flow would indicate an obstruction of the fourth ventricle foramina. (4) Gammacisternography is also indicated in cases where CSF leakage is suspected. Here the examination precisely locates the fistula (direct proof of which is given by the picture on the scan) or shows contamination of the adjacent tissues and fluids (indirect proof of fistula) .--M. Bettex.
693
of a Pudenz-Heyer valve in a case of congenital hydrocephalus, a boy aged 3 9/12 years developed a severe nephrotic syndrome complicated by macrohematuria, arterial hypertension and renal failure. Staphylococcus albus was present in the shunt valve. Renal biopsy revealed subacute glomerulonephritis. With immunohistochemical procedures precipitates of IgM, IgG and complement were demonstrated in the glomerula. After removal of the shunt all pathological renal findings disappeared except for slight residual proteinuria.--M. Bettex.
NEOPLASMS CHEMOTHERAPY, RADIOTHERAPY, AND HEPATIC LOBECTOMY FOR HEPATOBLASTOMA IN AN INFANT; REPORT OF A SURVIVAL. R. E.
Hermann and D. Lousdate. Surgery 68: 383-388 (August), 1970.
A hepatoblastoma in the right lobe of the liver of a fifteen month old boy at surgical exploration was deemed nonresectable. Vincristine, Cytoxin, and Cobalt 60 teletherapy resulted in a decrease in size of the tumor mass, the appearance of calcification, and a thriving child. Improvement was so dramatic that 8 months later (at 23 months of age) a right hepatic lobectomy was uneventfully carried out. Three years later the child remains well without evidence of any recurrent or residual tumor. This case is reported because of the unusual beneficial response of hepatoblastoma to radiation and chemotherapy.--William K. Sieber. TREATMENT
OF
NEUROBLASTOMA WITH
VITAMIN B.12. M. J. S. Langman. Arch. Dis. Child. 45:385-387 (June), 1970.
This is a report of a Medical Research Council working party investigating the value of vitamin B.12 in the treatment of neuroblastoma. While most people had abandoned B. 12 as a useful treatment for neuroblastoma the report on the clinical course of 134 paDIFFUSE GLOMERULONEPHRITIS DUE TO tients is of some importance. Twenty-six of INFECTED VENTRICULO-ATRIAL SHUNT these patients were unsuitable for analysis. ("SHUNT-NEPHRITIS"). U. G. Stauffer, A . Sixty-five had received treatment with vitaCsomor, H. J. Pliiss and W. H. Ititzig. min B.12 at some time during their illness Schweiz. Med. Wschr. 100:1288-1291, and 43 had no such treatment. Four of the 1970. treated group, however, had received the vitamin only by mouth, a treatment which Three years after successful implantation
ABSTRACTS incidence of scoliosis. This series consisted of 100 patients with 72 idiopathic curves, 10 congenital spinal deformations and 13 due to polio. There was a 5:1 female prepondera n c e . - - A n t h o n y H. Alter. THE INCIDENCE AND TREATMENT OF SCOLIOSIS IN CEREBRAL PALSY. G. A. Balmer and G. D. MacEwen. J. Bone Joint Surg. 52B: 134-137 ( F e b r u a r y ) , 1970. Twenty-one patients in 100 children with cerebral palsy had scoliosis of more than 10 degrees. Ten required surgery consisting of fusion with Harrington instrumentation, which was able to create a stable compensated spine.--Anthony H. Alter. ACUTE OSTEOMYELITIS IN CHILDREN. N. J. Blockley and J. T. Watson. J. Bone Joint Surg. 52B:77-87 (February), 1970. 113 patients with osteomyelitis over a 9year-period were reviewed. The most commonly cultured organism was staphylococcus aureus in 68 cases, resistant to penicillin in 49. The best results were obtained with antibiotic therapy for 3-12 weeks. Surgery was performed early in the series with little contribution to improvement. 21 cases failed to respond to antibiotics, including 13 patients who had surgery. Extensive bone involvement prior to onset of therapy resulted in the poorest prognosis for cure. A n elevated sedimentation rate was of some value in documenting persistent infection. Clinical assessment of bone tenderness was the other useful diagnostic t e s t . - - A n t h o n y H. Alter. FOOTBALL INJURIES IN THE VERY YOUNG ATHLETE. L. A. Roser and D. K. Clawson. Clin. Orth. 69:219-223 (March-April), 1970. The authors reviewed 2079 players participating in football leagues, separated by age and weight, in Seattle, Wash. There were a total of 48 football related injuries, fairly evenly distributed in all ages. Seventeen ( 3 5 % ) injuries were fractures, 17 sprains and strains with contusions, and eleven lacerations; two concussions and one dislocation comprising the rest. Injuries were more frequent in first string players who also had had more previous experience at football. Thirtythree of the injuries occurred in practice. The hand, knee, wrist, ankle and thorax sus-
ABSTRACTS
tained most of the injuries. A comparison of statistical data for children's injuries show football in Seattle to have less injuries than children get in day-to-day living.--Anthony H. Alter.
NERVOUS SYSTEM GAMMA-CISTERNOGRAPHY IN INFANTS AND
CHILDREN. R. Oberson. Schweiz. Med. Wschr. 100:867-874, 1970. Cisternography with 100 #Ci iodated serum-albumin was performed in 15 normal children and 34 pathological cases, in the age group of 2 months to 15 years. In the normal, movement and absorption of CSF are very rapid. Data obtained from pathological cases are manifold: (1) In the case of diffusely reduced leptomeningeal pericerebral permeability or local circulatory impairment at important crossroads such as incisural notch or optochiasmatic cistern, either constant or transitory ventricular contamination may be observed. This apparently reversed flow of CSF could be accounted for by an increased or newly developed absorptive function of the ependyme, and this phenomenon constitutes the main indication for surgical treatment of hydrocephalus. (2) If leptomeningeal permeability is only slightly and/or diffusely impaired, the bulk flow of CSF, i.e., absorption of some of its constituents, appears to be slowed. In this situation the patient should be followed at monthly intervals, in order not to miss the opportunity of surgical correction. (3) Absence of any apparent bulk flow would indicate an obstruction of the fourth ventricle foramina. (4) Gammacisternography is also indicated in cases where CSF leakage is suspected. Here the examination precisely locates the fistula (direct proof of which is given by the picture on the scan) or shows contamination of the adjacent tissues and fluids (indirect proof of fistula) .--M. Bettex.
693
of a Pudenz-Heyer valve in a case of congenital hydrocephalus, a boy aged 3 9/12 years developed a severe nephrotic syndrome complicated by macrohematuria, arterial hypertension and renal failure. Staphylococcus albus was present in the shunt valve. Renal biopsy revealed subacute glomerulonephritis. With immunohistochemical procedures precipitates of IgM, IgG and complement were demonstrated in the glomerula. After removal of the shunt all pathological renal findings disappeared except for slight residual proteinuria.--M. Bettex.
NEOPLASMS CHEMOTHERAPY, RADIOTHERAPY, AND HEPATIC LOBECTOMY FOR HEPATOBLASTOMA IN AN INFANT; REPORT OF A SURVIVAL. R. E.
Hermann and D. Lousdate. Surgery 68: 383-388 (August), 1970.
A hepatoblastoma in the right lobe of the liver of a fifteen month old boy at surgical exploration was deemed nonresectable. Vincristine, Cytoxin, and Cobalt 60 teletherapy resulted in a decrease in size of the tumor mass, the appearance of calcification, and a thriving child. Improvement was so dramatic that 8 months later (at 23 months of age) a right hepatic lobectomy was uneventfully carried out. Three years later the child remains well without evidence of any recurrent or residual tumor. This case is reported because of the unusual beneficial response of hepatoblastoma to radiation and chemotherapy.--William K. Sieber. TREATMENT
OF
NEUROBLASTOMA WITH
VITAMIN B.12. M. J. S. Langman. Arch. Dis. Child. 45:385-387 (June), 1970.
This is a report of a Medical Research Council working party investigating the value of vitamin B.12 in the treatment of neuroblastoma. While most people had abandoned B. 12 as a useful treatment for neuroblastoma the report on the clinical course of 134 paDIFFUSE GLOMERULONEPHRITIS DUE TO tients is of some importance. Twenty-six of INFECTED VENTRICULO-ATRIAL SHUNT these patients were unsuitable for analysis. ("SHUNT-NEPHRITIS"). U. G. Stauffer, A . Sixty-five had received treatment with vitaCsomor, H. J. Pliiss and W. H. Ititzig. min B.12 at some time during their illness Schweiz. Med. Wschr. 100:1288-1291, and 43 had no such treatment. Four of the 1970. treated group, however, had received the vitamin only by mouth, a treatment which Three years after successful implantation