An anatomical basis for the degree of displacement of the distal chevron osteotomy in the treatment of hallux valgus.

The purpose of this study was to define the amount of lateral displacement of the chevron osteotomy to obtain a 50% displacement of the capital fragment. While mathematical analyses exist to predict the degree of correction of the intermetartarsal 1-2 angle with a distal metatarsal osteotomy, no guidelines exist regarding the degree of displacement (translation) that allows sufficient bone contact to enhance union and maintain stability of the osteotomy. We have addressed this concern based on anatomical parameters.

Treatment of cysts of the acromioclavicular joint with shoulder hemiarthroplasty.

A chronic cyst overlying the acromioclavicular joint was managed in four patients, between July 1988 and September 1991. All patients had had previous unsuccessful aspiration and excision of the cyst with recurrence. Each cyst was associated with a chronic, massive defect of the rotator cuff; superior migration of the humeral head; and degenerative osteoarthrosis of the glenohumeral joint.

Multiple myeloma in a 25-year-old woman.

A 25-year-old woman with acute knee pain and a lytic area in the proximal femur was diagnosed as having multiple myeloma (MM). This case is one of only eight in patients younger than aged 30 years to meet modern diagnostic criteria for MM. Failure to consider MM in young individuals precludes early diagnosis and valuable time for treatment.

Amputation as a consequence of stroke.

The purpose of this study was to determine if a significant correlation exists between the side of hemiplegia caused by a cerebrovascular accident and side of a subsequent major lower-extremity amputation. We also attempted to determine if a relationship exists between the time from cerebrovascular accident to the amputation, or level of amputation, and any concomitant risk factors including diabetes mellitus, hypertension, heart disease, or cigarette smoking. Forty-seven patients were included in the study; 40 of the 47 had an amputation on the side of the hemiplegia, which represented a statistically significant relationship (chi 2 = 5.