Spondylolisthesis treated by bone graft

NEW

Section

SERIES VOL. III, No. 2

of Orthopedic

atrophy of the thigh muscIes. Temperature, pulse and respirations normal. Wassermann negative. Roentgenogram showed reaction marked epiphyseal sIipping of left hip with leg in adduction.

FIG. z.-EpiphyseaI

slipping

of hip. After

ELMER

P.

WEIGEL,

American Journal of surgery

187

had had a plaster cast applied for three months with no reIief. PhysicaI Examination : SmaII gir1, we11 nourished, norma except for a marked Iordosis in Iumbar region with some tiIting to the right.

operation.

Operation, September 28, 1926: SmithPeterson incision. Epiphysis was found to have sIipped down on the neck so that it was bareIy touching at its upper margin. There was considerable attempt at caIIus formation: With a broad osteotome the head was cut free from the neck and the leg was sharpIy abducted and by means of a periostea1 eIevator the epiphysis was skidded into its norma relation to the neck where it remained without suture. A double pIaster spica was appIied in marked abduction for eight weeks. November 13, 1926. Cast removed. Wound healed. Roentgenogram showed reIation of fragment good and caIIus present. No shortening at this time. Patient began waIking and now has no limp or pain. (No discussion) SPONDYLOLISTHESIS TREATED BONE GRAFT

Surgery

I .-Spondylolisthesis.

Anterior graft.

FIG. 2.-SpondyIoIisthesis.

Anterior graft.

FIG.

view.

Before

bone

After

bone

BY

M.D.

M. B., femaIe, aged twenty-eight years, seen by me December 28, 1925, compIained of rheumatic pains in her back for one and one-half years. The onset was gradua1 and not due to trauma. She had aIways been we11 and had been doing offIce work. FamiIy history negative for chronic diseases. She had consuIted doctors, had had antirheumatic treatment and aIso

view.

Motion of Iower spine Iimited and attempts cause pain. Marked muscIe spasm was present. Roentgenogram shows sIippinp of fifth Iumbar body forward on sacrum and some IateraI dispIacement to the Ieft. Wassermann reaction negative.

188

American Journal of Surgery

Section

of Orthopedic

Operation, January 6, 1926: Bone graft from tibia to third, fourth and fifth Iumbar spine and into sacrum (AIbee technique). Patient kept Aat in bed for eight weeks; then got about graduaIIy using crutches for three months. Fitted with a Iong heavy-boned corset. Rest and quiet for six months. Returned to work November, 1926. Now can waIk twenty bIocks without pain and is doing her previous work. (No discussion) OSTEOSARCOMA FOLLOWING LANTERN

(By

AIJGUST. ,927

to BeIIevue HospitaI, condition, where he

on account of his Ieg was given baking and

OF THE FEMUR FRACTURE

SLIDE

HENRY

Surgery

DEMONSTRATION

KELLER,

M.D.

invitation)

A man, aged forty-eight years, singIe, came to the Cancer HospitaI, September, 1926. Eighteen months previousIy he had jumped on the taiI-board of a truck and struck his right Ieg, but he paid no attention to this injury and continued to work. A few days Iater he began to fee1 sIight pains in his right knee,

FIG.

FIG.

2.

massage for awhiIe, without mann tests were negative.

reIief. Two Wasser-

I.

he noticed a smaI1 Iump there and began to waIk IameIy. The condition remained the same for six months. About that time the patient Ieft his job as moving van heIper for Iighter work in the kitchen. In January, 1926, he went

In August, 1926, whiIe intoxicated the man feII down on the street, injuring the same Iimb. He was taken by ambuIance to BeIIevue HospitaI, and a few days Iater it was noticed that there was fracture of the right femur. A