Where ankle fusion stands today.

A retrospective study involving thirty-six patients with thirty-seven ankle fusions was undertaken to assess the rate of fusion, the subjective and objective results, the residual subtalar and midtarsal movement, and the functional disability. Fusion occurred in thirty-one ankles (84 per cent). Twenty-four patients were reviewed, on average 7.5 years after fusion, and eighteen had good or excellent results; only four had been unable to return to their previous employment. The conclusion is that fusion is still a good treatment for the painful post-traumatic arthritis ankle, the resulting functional disability being minimal.

Combination drug therapy in treatment of Paget's disease of bone: clinical and metabolic response.

Twenty-seven patients with symptomatic Paget's disease of bone were randomly treated with mithramycin, glucagon, and calcitonin given either alone or in combination. Mithramycin, at a dose of fifteen micrograms per kilogram of body weight per day, proved to be a relatively safe drug and elicited a rapid response with only transient side effects. Calcitonin combined with mithramycin was the most effective therapy.

Knee arthrodesis: long-term results.

A review of 41 patients in whom knee fusion was performed mainly for degenerative arthritis and sepsis disclosed that only 15% of patients were without complications. Complications were numerous and appeared both early and late - persistent knee and back pain were the most common. Many patients were unable to return to work or to participate in social activities. The optimal position for fusion is 15 to 20 degrees of flexion, which results in a smoother gait and less difficulty for the patient in driving a car. Because of the continued refinement in total knee joint replacement, the indications for knee arthrodesis should be confined to the treatment of chronic infection and failed total joint replacement.