1. Congenital pseudarthrosis of the clavicle is described. 2. The distinction from cranio-cleido-dysostosis and from birth fracture is stressed. 3. Details are given of two patients reported in the literature and a further nine patients are described. 4. The embryology, natural history and treatment of the condition are discussed

Aims

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

We describe a syndrome combining abnormalities of the pelvis, knee and foot in three related patients with a familial history of small dislocated patellae. The clinical and radiological appearance of the patella and pelvis is consistent with the ‘small-patella’ syndrome, a rare autosomal dominant disorder. There were also previously unreported deformities affecting the feet

The case histories of five young children are presented to demonstrate the radiological appearances of trauma to the spine thought to be the result of maltreatment by either parent or guardian. Four of the children were admitted to hospital within a period of three years, all being under the age of two years

1. The history of microvascular surgery is reviewed; the necessary instruments and the technique of suture are described. 2. Modern trends in the experimental and clinical applications in orthopaedic surgery and traumatology are discussed. 3. The authors emphasise the usefulness of this technique in tissue transplantation and in the reconstruction of microvascular injuries of the musculoskeletal system

Aims

To compare the rates of sagittal and coronal correction for all-pedicle screw instrumentation and hybrid instrumentation using sublaminar bands in the treatment of thoracic adolescent idiopathic scoliosis (AIS).

1. Five cases of postero-lateral dislocation of the knee with capsular interposition are described. 2. The mechanism of the injury is considered in the light of the case histories and the findings at operation. 3. The constant clinical findings associated with this injury are described. 4. Open reduction is recommended: with early operation the prognosis for function and stability is good

A bulky compression dressing (the Robert Jones bandage) is often used by orthopaedic surgeons. We have reviewed its history and monitored intramuscular compartment pressure under it after total knee replacement. We found that it increased compartment pressure and helped to reduce bleeding, tissue oedema and the size of effusions and haemarthroses

A case is described of malignant osteoclastoma of the lower end of the femur in which death occurred from pulmonary metastases. The history was short and there was no interference with the primary growth, treatment being confined to disarticulation at the hip. Reasons are given for considering this neoplasm a malignant osteoclastoma rather than an osteogenic sarcoma, and the question of nomenclature is discussed

Aims

Robotic-assisted total knee arthroplasty (RA-TKA) has been introduced to provide accurate bone cuts and help achieve the target knee alignment, along with symmetric gap balancing. The purpose of this study was to determine if any early clinical benefits could be realized following TKA using robotic-assisted technology.

Aims

Cigarette smoking has a negative impact on the skeletal system, causes a decrease in bone mass in both young and old patients, and is considered a risk factor for the development of osteoporosis. In addition, it disturbs the bone healing process and prolongs the healing time after fractures. The mechanisms by which cigarette smoking impairs fracture healing are not fully understood. There are few studies reporting the effects of cigarette smoking on new blood vessel formation during the early stage of fracture healing. We tested the hypothesis that cigarette smoke inhalation may suppress angiogenesis and delay fracture healing.

We have previously reported in 57 patients (60 hips) with a past history of Legg-Calvé-Perthes’ disease at a mean of 34 years after the onset of symptoms. From this original group, 48 patients (51 hips) were also available for review after a mean of 50.2 years. We consider that the best prognostic indicator for the hip is the shape of the femoral head at skeletal maturity. Normal or flattened spherical heads present few problems. Irregular or very irregular heads are associated with a poor outcome

1. Forty-four patients with tuberculous tenosynovitis have been reviewed. 2. The lesions (fifty-two in all) are classified and described according to their anatomical sites. 3. Particular reference is made to the natural history of the condition and the results of treatment. 4. Early and extensive excision of the affected tendon sheaths combined with the use of anti-tuberculous drugs is recommended

1. The clinical, histological and radiological findings in 129 cases of histiocytosis X have been reviewed and the natural history of the disease is discussed. 2. Certain clinical and histological factors emerge as having prognostic significance. 3. The treatment in thirty-four personally reviewed cases is discussed and some suggestions are made as to the treatment of particular types of case

Hypophosphatasia in adults is rare. Two elderly sisters presenting with pathological fractures of the femur are reported to illustrate the difficulties in orthopaedic management of this disease. All patients with a history of repeated fractures, especially from minor trauma and with generalised radiological bony abnormality, should be screened for this rare disease. A consistently low level of serum alkaline phosphatase with the presence of phosphoethanolamine in the urine is diagnostic

1. A case is described in which a malignant tumour developed in the soft tissues at the site of a bone-plating operation performed thirty years before. 2. The plate and screws were found to be composed of dissimilar metals and a difference of potential existed between them. 3. A careful consideration of the history and clinical course indicates that the tumour arose because of the presence of the metals

1. The history of the genesis of the Putti-Platt operation for habitual dislocation of the shoulder is outlined so far as it is known. 2. The operation is described and briefly commented upon. 3. Since there is both gleno-labrial detachment and defect in the humeral head successful treatment depends upon: i) a block to the exit of the humeral head in front and ii) limitation of external rotation movement

Osteomyelitis is a rare manifestation of cat-scratch disease in patients who do not have AIDS. The clinical presentation and non-specific subacute course of the disease make diagnosis difficult. We present a child with osteomyelitis of a metacarpal following a dog scratch. Bartonella henselae was found to be the aetiological agent. The bone healed after treatment with antibiotics. Increased awareness and a comprehensive medical history are needed to identify patients with suspected Bartonella henselae osteomyelitis