A case of bilateral myositis ossificans in the biceps femoris muscles causing a sciatic nerve palsy on the left side is described. Complete recovery of the sciatic nerve followed excision of the mass of ectopic bone. It is postulated that the patient's hobby of weight-lifting caused the ossification

1. A bilateral case of chronic intermittent ischaemia of the soleus muscle within its fascial compartment is described in a dental surgeon aged twenty-seven. 2. Symptoms were promptly relieved by decompression. 3. The mechanism of the condition is compared with that of the anterior tibial syndrome

1. Two patients with bilateral pes cavus and lymphoedema are reported. Lymphography confirmed the existence of lymphatic insufficiency in both cases. In both there was evidence of hereditary factors in the etiology. 2. This familial syndrome appears not to have been previously reported

With advances in the treatment of patients with chronic renal failure, their life expectancy has increased. In turn, the prevalence of osteitis fibrosa cystica, a manifestation of secondary hyperparathyroidism, and β2 microglobulin amyloidosis, a result of long-term haemodialysis, has risen. While both conditions share similar radiological features, their management is very different. We present the case of a patient with renal failure who had been receiving haemodialysis for over 20 years. Lytic lesions had been observed in the proximal part of both femurs for ten years. A presumptive diagnosis of osteitis fibrosa cystica was made. However, no regression of the lesions occurred after parathyroidectomy. The patient subsequently developed sequential pathological fractures through the lesions, for which bilateral total hip replacements were performed. Histology of the lesions revealed that the patient was in fact suffering from amyloidosis. In patients with chronic renal failure, osseous amyloidosis is a highly probable differential diagnosis, especially if no regression of a lytic lesion is observed after parathyroidectomy

Premature epiphysial closure is an infrequent complication of Perthes' disease. Twenty-two patients with this condition are reviewed, three of whom were bilaterally affected. The aetiology, radiographic features and effect on function are discussed. The incidence of this complication can be reduced by an awareness of the clinical and radiographic signs which contra-indicate treatment by upper fermoral osteotomy

The findings in a child with bilateral congenital dislocation of the hips who died shortly after birth are described. The only significant abnormality present was redundancy of the capsular ligaments and elongation of the ligament of the femoral head. The relationship between the orientation of the femoral neck and of the acetabulum was within normal limits. The significance of these findings in relation to etiology and management are discussed

We report three cases of thoracic spine translocation without neurological deficit. In each case bilateral pedicular fractures, demonstrated by computed tomography, produced 'floating arches' which account for the sparing of the cord. If computed tomography demonstrates adequate canal dimensions, these patients may be treated conservatively, but the treatment of choice at specialist spinal centres is operative stabilisation

Aims

Carpal malalignment after a distal radial fracture occurs due to loss of volar tilt. Several studies have shown that this has an adverse influence on function. We aimed to investigate the magnitude of dorsal tilt that leads to carpal malalignment, whether reduction of dorsal tilt will correct carpal malalignment, and which measure of carpal malalignment is the most useful.

1. Five patients with seven fatigue fractures of the lower third of the tibia are described; two had bilateral fractures. There is a striking similarity in the site and appearance of these fractures. 2. All occurred in middle-aged or elderly people without a history of unusual activity or illness. 3. The fractures are so nearly identical as to constitute an entity which, as far as we are aware, has not been described before

1. A case of spontaneous fracture of a first rib is described. 2. Its evolution from a previously intact rib through the stage of a "linear" crack to pseudarthrosis has been traced. 3. An older pseudarthrosis was present on the opposite side. 4. Alderson's observation is confirmed—that the breach in the rib is acquired. There is no need to suppose a developmental anomaly of ossification, even in a bilateral case

Aims

There is an increasing demand for hip arthroplasty in China. We aimed to describe trends in in-hospital mortality after this procedure in China and to examine the potential risk factors.

We describe an operation to relieve compression of the lateral antebrachial cutaneous nerve at the elbow. Between 1987 and 1997 we operated on seven patients, one with bilateral compression. In two the compression was associated with injury to biceps. A longitudinal or a transverse incision was carried out and the nerve was released from the deep fascia. Partial excision of the biceps aponeurosis was undertaken in the patients who did not have injury to biceps; some additional procedures were required for those patients with injuries. All patients had symptomatic relief

We describe 11 children with fibular hypoplasia and three- or four-ray feet, two bilaterally. This deformity is a less severe form of the better known congenital short tibia with absent or dysplastic fibula. If the leg-length discrepancy is minor, no treatment or a simple orthosis are used. Epiphysiodesis or leg lengthening by callotasis is appropriate for mild to moderate discrepancy. If the foot is non-functional, or the projected leg-length discrepancy is too great, early amputation and a prosthesis are advised

In a survey of 6000 children between 9 and 10 years of age, 122 were found to have unilateral or bilateral hallux valgus. These children were randomly assigned to no treatment or to the use of a foot orthosis. About three years later 93 again had radiography. The metatarsophalangeal joint angle had increased in both groups but more so in the treated group. During the study, hallux valgus developed in the unaffected feet of children with unilateral deformity, despite the use of the orthosis

1. An account is given of a family in which five members in three generations were affected by osteochondritis involving the hips, in three cases bilaterally. 2. One patient showed aseptic osseous necrosis of the epiphyses of the ankles and fingers. 3. The differential diagnosis between Perthes' disease and multiple epiphysial dysplasia is discussed, but it is not certain into which category these patients fall. 4. The assistance of a family history and skeletal survey in diagnosis is illustrated

Aims

The EuroQol five-dimension (EQ-5D) questionnaire is a widely used multiattribute general health questionnaire where an EQ-5D < 0 defines a state ‘worse than death’ (WTD). The aim of this study was to determine the proportion of patients awaiting total hip arthroplasty (THA) or total knee arthroplasty (TKA) in a health state WTD and to identify associations with this state. Secondary aims were to examine the effect of WTD status on one-year outcomes.

Aims

The aim of this study was to report our experience at 3.5 years with outpatient total hip arthroplasty (THA).

One hundred shoulders were assessed in 50 patients with multiple epiphyseal dysplasia, of which one-third were found to have bilateral symptoms. Two distinct clinical and radiological groups emerged. Those with minor epiphyseal abnormalities developed painful osteoarthritis in middle age, but retained shoulder movement until the secondary changes were advanced. Those with 'hatchet head' shoulders likewise became painful in the fifth and sixth decades but had minimal glenohumeral movement from an early stage

A survey of 6000 schoolchildren discovered 36 cases of unilateral and 60 cases of bilateral hallux valgus, defined as a metatarsophalangeal angle of more than 14.5 degrees, measured on standing radiographs. Metatarsus primus varus was found not only in the early stages of hallux valgus but in the unaffected feet of children with unilateral hallux valgus. Adduction of the first metatarsal is not due to differential growth of the cortices of the first metatarsal nor is it a consequence of malalignment of the metatarsocuneiform joint. The intermetatarsal angle did not correlate with the angle of metatarsus adductus nor with the intercuneiform angle