ABSTRACT
The radiological assessment of knee deformity in the frontal plane is often fallacious because of the difficulty in determining the correct position of rotation of the lower limb. Deformity is under-estimated when the direction of the X-ray is not perpendicular to the frontal plane. To determine the frontal plane with accuracy the authors first looked for a true lateral view which is obtained when the posterior margins of the femoral condyles are superimposed. When the position of the patient has been determined by demonstrating the true lateral position, a second radiograph is taken using a large film in a plane at right angles to the preceding film. In this way a true frontal plane is obtained which requires no reference to the position of the foot or the patella which tends to be variable. An association flexion deformity does not invalidate the result. When this technique is used it can be shown that conventional methods tend to under-estimate the degree of knee deformity.
Subject(s)
Knee Joint/diagnostic imaging , Humans , Joint Diseases/diagnostic imaging , RadiographyABSTRACT
The authors have treated 9 cases of streptococcal gangrene of the limbs. They describe the clinical features:local oedema, erythema, and cyanotic spots. In 7 of the cases the infected general condition was very severe. At operation, the subcutaneous soft tissues were grey-green without pus. The authors have reviewed the literature and consider that treatment should be based on early excision of the skin and subcutaneous tissues. Antibiotics are of great help but are not sufficient by themselves. Nine patients reached a stable state but sequelae have been severe with one disarticulation of the shoulder, one ankylosis of the wrist, one ankylosis of the knee and one generalised stiffness of the hand. Only five patients have been completely cured.
