Previous reports concerning the treatment of symptoms deriving from prolapsed lumbar disc with systemic administration of the potent steroid dexamethasone, have shown favourable results. The present clinical study includes 39 patients with symptoms of prolapsed lumbar disc, treated in a controlled double-blind investigation with dexamethasone or placebo. Twenty patients had provable effect of the treatment, 19 had no effect. Nineteen patients received dexamethasone (13 + effect), 20 received placebo (7 + effect). The groups were fully comparable, and the difference is not statistically significant. During a period of 3 months 50% of the patients who improved by the treatment of either group had recurrences leading to operation. It is concluded that the effect of dexamethasone given intramuscularly does not seem to exceed that of placebo in the treatment of prolapsed lumbar disc.

The purpose of the present prospective study was to assess the value of 99m-Tc-MDP wrist scintigraphy performed as a routine examination in excluding or detecting carpal scaphoid bone fracture. The following conclusions are drawn: 99m-Tc-MDP wrist scintigraphy is of high sensitivity, but low specificity in the detection of scaphoid bone fractures. The scintigraphy is expedient to exclude scaphoid bone fracture, if performed after secondary clinical and radiographic assessment, and guided by negative scintigrams a reduction of clinical examinations, radiographies and superfluous casting days is achieved.

In 1927, Oluf Thomsen, in a classic paper, described a seven-generation family with autosomal dominant axial synpolydactyly (SPD)--the Vordingborgtyp of axis duplication and dysostosis. Expansion of a polyalanine tract in the HOXD13 gene is known to cause synpolydactyly. We have rediscovered part of the family described by Thomsen, and detected a 9 triplet polyalanine expansion within HOXD13segregating with the disorder. The phenotypic spectrum in mutation carriers ranged from severe to inapparent bone malformations. In the latter case, only dermatoglyphics revealed the genetic status.

We studied all cases of assault with violence (1,639) in a Danish population of 275,000 over a one-year period. Most victims were young men. The incidence rose during evenings, nights and weekends, and assaults were often seen in or around bars and restaurants. Women accounted for 64 per cent of all victims of assault in the home. Influence of alcohol was identified in 43 per cent of all cases. The fist was the most frequent agent of assault; use of firearms was a very rare act of violence but was associated with death in three out of five cases. There were 10 deaths in all. (Am J Public Health 1985; 75:651-653.)

Twenty-one ankle joints with recurrent lateral instability, treated with surgical repair by the Watson-Jones method, were included in a follow-up study 1--5 years after operation. Good results were achieved in 80 per cent. However, the results were not better than those after free dissection and direct suture of the ligamentous ruptures. It is therefore recommended that the more extensive Watson-Jones procedure be reserved for selected cases.

The function of the posterior talofibular ligament was studied using an apparatus which subjected the ankle joint to a measured torque and allowed the simultaneous recording of rotatory movements in two planes. Thirty osteoligamentous preparations of ankle joints were examined, half in the sagittal and horizontal planes and the remainder in the sagittal and frontal planes. Successive section of the lateral collateral ligaments was performed, including, in particular, selective division of the short and long fibres of the posterior talofibular ligament. The function of this ligament was investigated in combination with the other two collateral lateral ligaments, with the calcaneofibular ligament alone, and finally as the only remaining intact ligament. The posterior talofibular ligament plays only a supplementary role in ankle stability when the lateral ligament complex is intact. After rupture of the anterior talofibular and the calcaneofibular ligaments, however, the short fibres of the posterior ligament restrict internal and external rotation, talar tilt, and dorsiflexion, while its long fibres inhibit only external rotation, talar tilt, and dorsiflexion. As the posterior talofibular ligament has no independent stabilizing function in the intact ankle joint, an isolated rupture of this ligament is unlikely.

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