Fracture of the femoral head without associated hip dislocation following low-energy trauma. A report of two cases.

Two cases of fracture of the femoral head are reported in which no associated hip dislocation occurred after low-energy trauma. This unusual injury can be missed. A possible mechanism for this rare occurrence has been suggested.

Fracture through the bone of traumatic myositis ossificans. A report of three cases.

We describe three cases of traumatic myositis ossificans in which fractures occurred through a mature, quiescent ossification mass. None of the fractures reactivated the original pathological process, no callus was formed and union did not occur. The nonunion became painless over a period of months. This unusual late complication of myositis ossificans seems to require only symptomatic treatment by temporary splintage and subsequent mobilisation. We could find no previous report of a similar case.

Pseudoaneurysm of external iliac artery and compression of external iliac vein after total hip arthroplasty. Case report.

Serious vascular injury as a delayed complication of total hip arthroplasty is unusual. A case of pseudoaneurysm of the external iliac artery and compression of the external iliac vein following loss of acetabular fixation in an uninfected case is reported. There is no previous report of such a complication occurring in the absence of infection, which is considered by some as the main predisposing factor for the event.

The ABC carbon and polyester prosthetic ligament for ACL-deficient knees. Early results in 31 cases.

We treated 39 knees with chronic deficiency of the anterior cruciate ligament by reconstruction using the ABC carbon and polyester prosthetic ligament; 31 (79.5%) were reviewed at an average follow-up of 34 months. There had been four complete failures requiring revision. The remaining 27 were studied in detail. On the Lysholm rating, only 11 knees (41%) had good results with a score of over 76. The mean anterior drawer movement was reduced from 7.6 mm before operation to 5.8 mm at review. The mean difference from the opposite uninjured knee was 3.9 mm before operation, 1 mm (in 21 patients) at mean follow-up of 7.4 months and 2.5 mm (in 27 patients) at 34 months, indicating progressive loss of effect. In our opinion the results are unsatisfactory: we do not recommend the use of this prosthetic ligament.

Nonunion of fractures of the scaphoid tuberosity.

Fracture of the tuberosity of the scaphoid is common and usually heals without incident because of the good blood supply. We report four cases of nonunion of this fracture. Three of them were symptomatic and two required operative treatment.

The reliability of ultrasonographic assessment of neonatal hips.

Ultrasound scans were made of the hips of 209 neonates born consecutively over a two-week period. Of the 418 scans, 62 images were selected at random and 25 of these were duplicated to give a total of 87 scans. These static images were then presented to five experienced observers who each made nine different assessments and measurements. Interobserver and intraboserver agreement was calculated and expressed as kappa values. Our results showed poor reliability on both counts.

Recurrent anterior glenohumeral joint dislocation and torsion of the humerus.

Two computerized axial tomographic sections, one taken just below the coracoid process and the other about 2.5 cm proximal to the interepicondylar line, were used to determine glenoid version and humeral torsion in 19 patients with recurrent anterior glenohumeral joint dislocation and in 23 controls. Analysis of interobserver variation revealed the method to be reliable. There was no difference in glenoid version between the two groups. However, humeral torsion was greater in patients (153 degrees) than in controls (144 degrees). It appears that increased humeral torsion may predispose to glenohumeral joint dislocation.

Carpometacarpal dislocation of the thumb associated with fracture of the trapezium.

Dislocation of the first carpometacarpal joint combined with a vertical intra-articular fracture of the trapezium is a rare injury. A case is described treated by open reduction of the trapezial fracture and reconstruction of the first intermetacarpal ligament using a slip of abductor pollicis longus tendon.

A simple clinical test to differentiate rupture of flexor pollicis longus and incomplete anterior interosseous paralysis.

Incomplete anterior interosseous nerve paralysis and spontaneous rupture of flexor pollicis longus tendon are conditions which mimic each other closely and have been mistaken for each other, leading to unnecessary surgery. This is a report of a simple and reliable clinical test to differentiate between the two conditions. A search of the literature has not revealed a previous description of this test.