1. The results are presented of upper tibial osteotomy carried out in ten patients for osteoarthritis of the knee associated with lateral deformity. 2. The operation is indicated when there is severe pain, valgus or varus deformity, and a range of flexion of at least 90 degrees. 3. In every case pain has been relieved, and recovery of movement after operation has been easy.
THE choice of treatment lies between arthrodesis of the terminal interphalangeal joint, tenodesis or restoration of tendon action by tendon grafting. The decision depends upon age, state of the finger, the occupation and the wishes of the patient. Tendon grafting is an operation of some magnitude for a comparatively small disability and should only be undertaken by the surgeon experienced in this work and when the patient is determined to seek perfection.Analysis of 33 consecutive cases operated upon by tendon grafting during the past eighteen years reveals 4 failures. Of the remaining 29 cases, 92 % attained 30 degrees or more flexion range at the terminal interphalangeal joint and 55% reached to within half an inch or less of the distal palmar crease. In no case was the finger harmed by surgical intervention.(A film demonstrating the technique of the operation was presented.) Tibial
1. A series of 226 upper tibial osteotomies is reviewed with special reference to the complications occurring in each of the six different operative techniques that have been used. 2 Wedge osteotomy above the tuberosity is the safest operation, but care must be taken to avoid a fracture into the joint. 3. Wedge osteotomy through the lowest part of the tuberosity may be indicated in the presence of large subarticular cysts or collapse of a tibial condyle. 4. The significance of weakness of dorsiflexion of the foot and the dangers of injury to the anterior tibial artery in osteotomies below the tuberosity are discussed.
This paper describes a prospective trial which was set up in order to decide whether after knee replacement it is better to remove the tourniquet (pneumatic cuff) before closure of the wound or to leave it on until compressive dressings have been applied. In 80 operations studied, there was less blood loss when the tourniquet was removed after closure and bandaging, but there was no difference in wound complications. The only statistically significant difference was attributed to the timing of tourniquet removal in those patients (about half) who were receiving low-dose heparin.
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