Long-term evaluation of a novel surgical approach to the pseudotumour of the ilium in haemophilia: exeresis and transposition of the omentum in the residual cavity.

Pseudotumour of the ilium is a rare but severe complication in haemophiliacs. Excision is often complicated by infections, fistulation and extensive pelvic bone destruction. In 1978, the first author carried out excision of the pseudotumour with transposition of the omentum in the dead cavity to avoid recurrence. This type of surgery has been carried out in three additional patients. The long follow-up of these four patients suggests that this procedure is feasible and curative; local bleeding, infection and fistulation did not recur and the patients remained ambulant with the aid of appropriate devices.

Posterior hip dislocation with slice fracture of the femoral head: removal of the cephalic fragment.

Three patients with posterior dislocation of the hip associated with Pipkin type II fracture of the femoral head were treated surgically by removal of the cephalic fragment, as closed reduction had not been satisfactory. The clinical and radiographic results were good after 1 year, and none of the patients showed radiographic signs of avascular necrosis.

A rare case of intraspinal ganglionic cyst.

The authors describe a case of intraspinal extradural ganglionic cyst. This is a rare condition which has not previously been reported in the literature. The differential diagnosis is discussed.

The medium-term results of cementless Lord-type hip prosthesis.

The results of 58 cementless total hip prostheses (Lord madreporous type) were evaluated 4 to 7 years after implantation. The functional results were generally satisfactory, although in approximately half the cases some pain was still present. Radiographic examination allowed us to analyse the response of the diaphyseal bone to the different situations of the endomedullary implant. Acetabular wear, which is one of the factors which may influence the long-term results, was also evaluated.

Tibial tubercle advancement by the Maquet technique for patellofemoral arthritis or chondromalacia.

The authors report 19 operations according to the Maquet technique for patellofemoral arthritis or chondromalacia between 1977 and 1984. The same procedure and technique were used in all cases but the results were better in chondromalacia which were good in 64% of the cases compared with 38% in arthritis. After discussing the problems of clinical and radiographic evaluation, the authors conclude that after a long period of rehabilitation satisfactory results are obtained in chondromalacia, while only limited success is achieved in arthritis.

Clinical and statistical comparison between the Lord and Mittelmeier total hip prostheses.

After a five year experience with two models of uncemented total hip prosthesis (Lord model and Mittelmeier model), two surgical teams analysed and compared the results in 88 cases with a view to ascertaining if there were any advantages of one model over the other. This was a prospective survey recording the standard parameters of assessment commonly accepted, and was subjected to statistical analysis. The results showed no superiority of one model over the other but they have reinforced our conviction of the superiority of uncemented prostheses over the cemented type.

Traumatic loosening of a prosthetic acetabular cup in a young patient.

The authors present a case of loosening of the acetabular cup of a total prosthesis resulting from an injury which caused a fracture of the acetabulum. This does not appear to have been previously recorded in the literature. This case also presented a problem of treatment and emphasizes the need for intercompatibility of prosthetic components should only one need replacement. Bone grafts were used in this case to reinforce the acetabular roof for the secure seating of a replacement cup--in this case a cementless acetabular component screwed into the bony acetabulum.

A case of spontaneous cure of spondylolisthesis in adolescence.

The writers present a case of spontaneous cure of spondylolytic spondylolisthesis in a child aged twelve, which resulted in an almost perfect result within three years. This is an extremely rare occurrence, only five cases having previously been reported.