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Plantar pressures in healthy children and in children with myelomeningocele
ABSTRACTS
anatomical study of club foot in different stages of fetal development. Dissection of both feet of eight fetuses with unilateral club foot was carried out. Manipulation of the deformed foot was carried out in all cases before dissection. The tali were then removed and as the vascular trees could not be demonstrated by injection, this was done by radiographs of three sections cut from the center of the bone. The head-neck angle was made with particular care. Only three feet could be manipulated into the plantigrade position. No abnormality was found in the dissected vessels and nerves. Gastrocnemius muscle was smaller in all but its insertion was normal. Tibialis anticus was normal in all but one and positions normal in all but three. The most striking feature of all, however, was the deformity of the talus and especially in the declination angle, this deformity being present only in the group (5) which could not be manipulated. Feet that could be manipulated had normal tali. The proposition that the angle of declination increased during fetal development was not confirmed and the angle was within the normal range in all normal feet, implying possibly that the deformity is due to a real defect in the talus and not to any growth arrest.--/. Airken Residual Adduction of the Forefoot in Treated Congenital Club Foot. L. B’. Lowe and M. A. Hannon. JBJS 55B: 809-813 (November), 1973. This survey was undertaken to determine the incidence and cause of residual adduction of the forefoot after conventional methods of treatment of congenital club foot. Seventy-three club feet in 51 children were reviewed: 52% of the feet were found to have residual adduction, and of these 74”/, had metatarsus varus. A radiological method of measuring metatarsus varus is described and illustrated. This depends on the navicularr metatarsal angle. To avoid this residual deformity the authors recommend that at the same time of posterior release in the first year of life (Lloyd-Roberts 1971) the origin of abductor halucis should be detached with tenotomy of the tendon of insertion at the same time.-l. Aitken
799
Thirteen cases of osteomyelitis of the calcaneus and talus in youngsters are presented and the treatment reviewed.-Anthony H. Alrer M.K.R. MacKenzie, H. M. Coovadia and L.S. Naidoo. S. Afr. Med.
Salmonella Osteomyelitis.
J. 48591-592 (March), 1974 Between 1926 and 1965 only six cases of osteomyelitis due to Salmonella ryphi were reported. Other Salmonella strains are an even less frequent cause of osteomyelitis. An unusual case of disseminated Salmonella dublin infection in an infant is documented. The dominant localization of lesions to the metacarpal and metatarsals is regarded as an uncommon complication.--- M.R.Q. Davies Plantar Pressures in Healthy Children and in Children with Myelomeningocele. Malcolm Hay. JBJS 55B:828-833 (November). 1973. Pressure sores in the feet of children with neurologic defects due to myelomeningocele are becoming an increasing problem. The research outlined in this paper showed that there was a definite increase in static plantar pressures of normal children during growth. The static plantar pressures of 78 children with myelomeningocele were estimated by the same method, which is described, and found to be well above the normal average level. The authors believe that this increase in perpendicular statis pressure during growth must be relevant in the production of trophic foot ulceration in children with myelomeningocele. They think that “flail deformity” of these paralyzed limbs also plays an important part.--J. Aifken NERVOUS
SYSTEM
Expanding Skull Fracture of Childhood, D. P. Addy. Br. Med. J. 4:338-339 (November), 1973. The case report is that of a 2-yr 8-mo-old infant who was found on admission with convulsions to have an expanding fracture of skull. The fracture had been sustained when the patient was 1 yr 4 mo old. The literature on the subject is reviewed.--/. C. Grant The Growing-Skull
Fracture
of Childhood.
P. M. Leary and B. J. Cremin. S. Afr. Med.
J. 48:415-416 (March), 1974. Osteomyelitis of the Calcaneus and Talus. D. Antoniou and A.N. Conner. JBJS %A:338345 (March), 1974.
Two infants documented with prior significant head trauma, were found to have localized bony defects in skull on x-ray evaluation. Full
anatomical study of club foot in different stages of fetal development. Dissection of both feet of eight fetuses with unilateral club foot was carried out. Manipulation of the deformed foot was carried out in all cases before dissection. The tali were then removed and as the vascular trees could not be demonstrated by injection, this was done by radiographs of three sections cut from the center of the bone. The head-neck angle was made with particular care. Only three feet could be manipulated into the plantigrade position. No abnormality was found in the dissected vessels and nerves. Gastrocnemius muscle was smaller in all but its insertion was normal. Tibialis anticus was normal in all but one and positions normal in all but three. The most striking feature of all, however, was the deformity of the talus and especially in the declination angle, this deformity being present only in the group (5) which could not be manipulated. Feet that could be manipulated had normal tali. The proposition that the angle of declination increased during fetal development was not confirmed and the angle was within the normal range in all normal feet, implying possibly that the deformity is due to a real defect in the talus and not to any growth arrest.--/. Airken Residual Adduction of the Forefoot in Treated Congenital Club Foot. L. B’. Lowe and M. A. Hannon. JBJS 55B: 809-813 (November), 1973. This survey was undertaken to determine the incidence and cause of residual adduction of the forefoot after conventional methods of treatment of congenital club foot. Seventy-three club feet in 51 children were reviewed: 52% of the feet were found to have residual adduction, and of these 74”/, had metatarsus varus. A radiological method of measuring metatarsus varus is described and illustrated. This depends on the navicularr metatarsal angle. To avoid this residual deformity the authors recommend that at the same time of posterior release in the first year of life (Lloyd-Roberts 1971) the origin of abductor halucis should be detached with tenotomy of the tendon of insertion at the same time.-l. Aitken
799
Thirteen cases of osteomyelitis of the calcaneus and talus in youngsters are presented and the treatment reviewed.-Anthony H. Alrer M.K.R. MacKenzie, H. M. Coovadia and L.S. Naidoo. S. Afr. Med.
Salmonella Osteomyelitis.
J. 48591-592 (March), 1974 Between 1926 and 1965 only six cases of osteomyelitis due to Salmonella ryphi were reported. Other Salmonella strains are an even less frequent cause of osteomyelitis. An unusual case of disseminated Salmonella dublin infection in an infant is documented. The dominant localization of lesions to the metacarpal and metatarsals is regarded as an uncommon complication.--- M.R.Q. Davies Plantar Pressures in Healthy Children and in Children with Myelomeningocele. Malcolm Hay. JBJS 55B:828-833 (November). 1973. Pressure sores in the feet of children with neurologic defects due to myelomeningocele are becoming an increasing problem. The research outlined in this paper showed that there was a definite increase in static plantar pressures of normal children during growth. The static plantar pressures of 78 children with myelomeningocele were estimated by the same method, which is described, and found to be well above the normal average level. The authors believe that this increase in perpendicular statis pressure during growth must be relevant in the production of trophic foot ulceration in children with myelomeningocele. They think that “flail deformity” of these paralyzed limbs also plays an important part.--J. Aifken NERVOUS
SYSTEM
Expanding Skull Fracture of Childhood, D. P. Addy. Br. Med. J. 4:338-339 (November), 1973. The case report is that of a 2-yr 8-mo-old infant who was found on admission with convulsions to have an expanding fracture of skull. The fracture had been sustained when the patient was 1 yr 4 mo old. The literature on the subject is reviewed.--/. C. Grant The Growing-Skull
Fracture
of Childhood.
P. M. Leary and B. J. Cremin. S. Afr. Med.
J. 48:415-416 (March), 1974. Osteomyelitis of the Calcaneus and Talus. D. Antoniou and A.N. Conner. JBJS %A:338345 (March), 1974.
Two infants documented with prior significant head trauma, were found to have localized bony defects in skull on x-ray evaluation. Full