A new device to treat intra-capsular fracture neck of femur non-union.

In adolescents and young adults, femoral neck fractures often result from high-velocity trauma. These fractures are usually of vertical shear pattern. There is an increased incidence of avascular necrosis and non-union, which is difficult to treat. Non-union of fractured neck of femur in young adults is a serious problem. There is growing evidence that these fractures should be treated with an angle-stable device to improve biomechanics at the fracture site. An ideal implant should prevent varus deformation and retroversion of the fracture in order to prevent failure of the osteosynthesis and thus preventing cut-out of implant and non-union at the fracture site. We report the first use of an Orthofix Gottfried Percutaneous Compression Plate (PC.C.P.) (Orthofix, Guilford, UK) to treat a non-union of an intra-capsular fractured neck of femur. We recommend this, in combination with autologous bone grafting, via a mini hip modification of the Smith-Petersen approach.

A case of dissociation of polyethylene from its metal baseplate in a "one piece" compression-moulded AGC tibial component.

The Anatomic Graduated Component (AGC) total knee arthroplasty is a commonly used prosthesis with good long-term results. This longevity is thought to be due to the technique of manufacture of the polyethylene and its "one piece" design reducing backside wear. Despite the perception of the AGC tibial component being a monobloc, we report a case of dissociation of the polyethylene from the baseplate.

Meralgia paraesthetica. A complication of a patient-positioning device in total hip replacement.

We describe three patients who developed meralgia paraesthetica after the use of a well-padded and carefully-placed patient-positioning device in total hip replacement.

Compartment syndrome following ankle fracture-dislocation: a case report.

Compartment syndrome in association with ankle fracture is extremely rare. The few reported cases involved the deep posterior compartment and were diagnosed late. We show that prompt recognition of this rare problem and early fasciotomy with fracture fixation prevents the long-term sequelae seen in all previously reported cases.

Dislodgement of the femoral component of a total hip arthroplasty presenting through the buttock.

The end result of nonsurgical management of the infected loose femoral component of a total hip arthroplasty is presented. This is the expulsion from the body of the foreign material.

Irreducible Lisfranc's injury: the 'toe up' sign.

A new physical sign (the 'toe up' sign) is described in relation to an irreducible Lisfranc injury, the cause being the interposed lateral slip of the tibialis anterior tendon. Surgical exploration is advocated.

Neurological complications of high tibial osteotomy--the fibular osteotomy as a causative factor: a clinical and anatomical study.

A clinical study of 105 upper tibial osteotomies was undertaken to investigate the incidence, pathology and outcome of perioperative neurological deficit. Motor weakness and/or sensory deficit occurred in 21 patients (20%) and in half of these the deficit was permanent. For descriptive purposes the fibula was divided into four zones. The occurrence of a neurological deficit was clearly related to the level of the fibular osteotomy. An anatomical explanation is proposed for this complication, based on cadaveric studies. Due to unacceptably high levels of complications it is recommended that the fibular osteotomy should not be performed in zones II and III (from just below the fibular head to 15 cm distal to this level).

Isolated tuberculosis of a skeletal muscle.

A case is described of tuberculosis in the muscle belly of abductor pollicis longus in a 25-year-old Asian woman. The complaint was of swelling and, as there was no evidence of tuberculosis elsewhere, the diagnosis was not made until the lump was explored surgically.

The analysis of cadmium in marine samples.

This paper describes a procedure for extracting cadmium from seawater and from whole-organism digests of the gastropod mollusc Mytilus planulatus (common mussel) prior to analysis by atomic absorption spectrophotometry (AAS). The individual whole mussels were dehydrated to constant weight at 50 degrees C, digested under simple reflux in nitric acid, and the solution buffered to pH 5 with sodium hydroxide and sodium citrate. The cadmium was extracted into dithizone in methyl isobutyl ketone and the organic layer stored in polyethylene containers for analysis by AAS. Seawater samples were treated in the same way, without dehydration. At each step in the sample preparation, the method was tested to ensure that no significant loss or contamination had occurred.