Shortening of the femoral neck and proximal displacement of the greater trochanter are the principal complications following avascular necrosis of the capital epiphysis head in early childhood. We report here the long-term follow-up of a series of osteotomies performed to lengthen the femoral neck and thus to restore the normal anatomy and function of the hip joint. Out of a sample of 24 patients, 15 (62.5%) were reviewed at the end of a mean follow-up of 10 years and 2 months. Fourteen of them (93.3%) had originally complained of pain on walking which varied in severity. After the operation, five were free from pain at the end of the follow-up, 9 still experienced pain on walking, and 1 also reported pain at rest. Before the operation, a positive Trendelenburg's sign was found in 8 of the patients. This was still present in 2 at follow-up. The average perpendicular distance from the center of the femoral head to a horizontal plane passing through the tip of the greater trochanter (the centro-trochanteric distance) was reduced from 33 mm to 7 mm. Apart from correcting the anatomical deformity, it is suggested that this operation may well provide lasting relief from pain and increase the power of the abductor muscles. It may also delay the onset of osteoarthritic change and in this way postpone the necessity for an endoprosthesis.

Die Diagnostik monozytär-leukämischer Hautinfiltrate war vor der Einführung enzymhistochemischer Methoden problematisch. Mit Hilfe der in den letzten Jahren entwickelten Verfahren kann unter Verwendung nichtchlorierter und chlorierter Naphtholderivate als Substrat ein Esterase-Enzymmuster dargestellt werden, das zusammen mit zytomorphologischen Kriterien die Differenzierung verschiedener Leukämieformen nicht núr in Blutausstrichen, Knochenmark-und Lymphknotenpunktaten ermöglicht, sondern auch in den bei diesen Krankheiten gelegentlich zu beobachtenden Hautinfiltraten. Diese Möglichkeiten werden an zwei Fällen von Monozytenleukämie mit sekundärer Hautbeteiligung geschildert.

Synovial haemangioma of joints are rare, but usually affect the knee joints of children and adolescents. Recurrent swelling, usually due to haemarthrosis, and intermittent pain may be present for a long time before the diagnosis is made. In this case report the common features of the condition are described, with emphasis on the occurrence of atraumatic haemarthrosis in children. The value of arthroscopy in diagnosis is discussed.

The authors present the results of 20 corrective procedures for juvenile cyphosis using Harrington compressive rods and Hibbs spondylodesis. 16 procedures date back more than one year (average 3 years, 4 months). 10 cases of pure dorsal cyphosis. The pre-operative Cobb-angles for cyphosis averaged 52 degrees, postoperatively an average of 24 degrees was measured. This reflects a 57 p.c. average immediate correction (41 p.c. for pure dorsal cyphosis, 71 p.c. for dorso-lumbar cyphosis) following surgery nearly all cases showed a significant loss of correction (average 43 p.c., dorsal 37 p.c., dorso-lumbar 49 p.c.). Three main reasons for this loss of correction are discussed and documented in detail. 1. Mal-centered and too short a length of spondylodesis; 2. insufficient corrective growth of wedge shaped vertebral bodies post surgery and 3. frequent lumbar decompensation into total round back deformity of the pure thoracic spondylodesis. The following changes in procedure to solve the problem of loss of correction are proposed. 1. Combined posterior and anterior fusions and 2. upper lumbar dorsal fusion together with extended thoracic spondylodesis. The changing indication is discussed. The main but not fatal complication was postoperative wound infection (15 p.c.).

Infrared thermography was proved to be a valuable additional technical instrument for diagnosis of LE, but is not an appropriate instrument to predict the clinical outcome in patients treated with ESWT. A noted reduction of skin temperature on the treated side is not due to specific effects of the shockwaves. It is unlikely that ESWT as applied has an influence on thermal regulation in the target area. These findings are supported by negative results of experimental and clinical trials.