No abstract

A controlled trial of one- and two-layer inverting techniques of sutures for the contruction of high and low colorectal anastomoses was conducted on 137 patients, the integrity of the suture lines being assessed clinically and by routine radiological examination after a small Gastrografin enema. A clinical diagnosis of anastomotic leakage was made in 9 patients (or perhaps more accurately in 5 only), but subclinical dehiscence was demonstrated radiologically in a further 39 patients (or perhaps 43). There was a slightly greater incidence of dehiscence after the one-layer technique of suture for both high and low anterior resection.

SUMMARY 112 actively parachuting sport (free fall) parachutists with more than 200 descents each and 109 veteran military parachutists no longer active returned a postal questionnaire about their parachuting activities, injuries, and current and past musculoskeletal symptoms. A high frequency of fractures and injuries was reported by each group, both in relation to parachuting and to other activities. 58 sport parachutists aged 23 to 57 years (mean 33-3 years) had weight-bearing anteroposterior and lateral radiographs taken of each knee. These showed a prevalence of radiological osteoarthrosis of 10-4 % which was mild in degree in all but one knee in one subject. 46 ex-military parachutists aged 50 to 70 years (mean 552 years) had weight-bearing anteroposterior radiographs taken of both knees and showed a prevalence of radiological osteroarthrosis of 41 -3 %. Moderate and severe changes were found in 10-9 %. In both groups of parachutists six of the eight knee joints showing either moderate or severe radiological osteroathrosis had been subjected to a previous meniscectomy.Forty ex-military parachutists had anteroposterior radiographs of the ankles (talotibial articulation) and showed a prevalence of osteoarthrosis of 17-5 %, with the majority showing mild changes. There was a poor correlation between radiological osteoarthrosis, ankle symptoms, and previous fractures.With the reservation that the great majority of the sport group are still young (95 % aged <50 years), it is concluded that parachutists as a group do not show an increased prevalence of radiological osteoarthrosis of the knee or ankle.

No abstract

A personal experience of 26 reservoir ileostomies is reviewed. There were no operative deaths, but 3 patients developed non-fatal faecal fistula and 6 patients eventually had their reservoir removed for a variety of reasons. No patient given a reservoir without an intussusception valve was fully continent, but of 15 patients with a reservoir incorporating such a valve who were followed up, 9 enjoyed complete continence, though 2 experienced periodic difficulty with stomal intubation. The indications for this operation are discussed.