Multiple-view scintigraphy for localization of osteoid osteoma.

A circumscript accumulation of 99mTc-MDP in the spine of a patient, presenting with back pain and negative radiographs, was histologically confirmed to be an osteoid osteoma. As radiological procedures failed to localize the lesion, this was accomplished by means of posterior and lateral view bone scintigrams as well as by single photon emission tomography. The role of scintigraphy in patients suspected of having osteoid osteoma and the possibility of localizing the lesion before and during surgical intervention are underlined.

Incidence of fracture through metastases in long bones.

A knowledge of the incidence of fractures through metastases of various sizes in long bones is important when considering prophylactic internal fixation. The notes and X-rays of 66 consecutive patients with 100 metastases in long bones were analysed. Fractures are highly unlikely to occur (2.

The GSB knee prosthesis.

In the three years' period 1976-1978, 53 GSB knee prostheses were inserted in 46 patients. The use of this type of prosthesis was mainly indicated for the relief of pain in the presence of severe deformity or ligamentous insufficiency. There were two subsequent arthrodeses, one for infection and one for persistent pain.

A dynamic approach to the thumb-in palm deformity in cerebral palsy.

One hundred and sixty-five different surgical procedures were performed for the correction of thumb deformities in fifty-six patients with spastic cerebral palsy at Gillette Children's Hospital, St. Paul, Minnesota, between 1967 and 1975. The quality of voluntary muscle control and sensibility were the most important factors in predicting the success of operation.

Atlanto axial rotatory fixation--a cause of torticollis.

Atlanto-axial rotatory fixation is a rare but important cause of persistent torticollis. The diagnosis is confirmed by careful radiological examination of the atlanto-axial joint, also employing tomography if necessary. Treatment is skull traction in an attempt to improve the position followed by posterior atlanto-axial fusion to prevent further, and potentially disastrous, displacement.

The management of secondary neoplastic deposits in long bones by prophylactic internal fixation.

Pathological fracture through a secondary neoplastic deposit is a distressing event. Prevention of such a fracture is clearly of considerable benefit. To determine which secondary deposits are liable to fracture the notes and X-rays of 57 patients with 91 secondary deposits were examined.

Muscle imbalance in the aetiology of scoliosis.

At the apex of an idiopathic scoliotic curve there is a greater proportion of "slow twitch" muscle fibres in multifidus on the convex as compared to the concave side. To determine whether this represents a primary muscular imbalance relevant to the aetiology of idiopathic scoliosis or merely a secondary change, the lengths of multifidus on opposite sides of the curve were measured. Multifidus is shorter on the convex side.

Myosin ATPase activity in multifidus muscle from cases of lumbar spinal derangement.

Biopsies of lumbar multifidus muscles were obtained at operation on seventeen patients aged from fifteen to fifty-eight with lumbar spinal derangement, and further material was taken from the cadavers of three subjects aged from nineteen to fifty-one. Sections were prepared to show the presence of ATPase activity, so distinguishing Fast from Slow types of muscle fibre. The normal mosiac pattern arising from the intermingling of fibres from Fast and Slow motor units was seen in sections from cadaveric material and from many of the biopsies.

Automatic transmission vehicle injuries.

Four drivers sustained severe injuries when run down by their own automatic cars while adjusting the carburettor or throttle linkages. The transmission had been left in the "Drive" position and the engine was idling. This accident is easily avoidable.

Prophylactic internal fixation of secondary neoplastic deposits in long bones.

The notes and radiographs of 19 patients who had pathological fractures of long bones due to secondary neoplastic deposits were reviewed. Involvement of over half of the cortex is recommended as an indication for prophylactic internal fixation to prevent the development of a pathological fracture. Eight patients were treated successfully in this way.