The efficacy of the anterolateral pinning of moderate and severe slipped capital femoral epiphysis (SCFE) was studied both mechanically and clinically. The mechanical stability of anterolateral pinning was equivalent to that of conventional lateral pinning as shown by study in 16 immature porcine hips. The clinical results in the group pinned from the anterolateral approach were superior in that fewer complications occurred as compared with the traditional lateral approach. The group with anterolateral pinning had 2 complications in 13 hips, whereas lateral pinnings resulted in 8 complications in 28 hips. We recommend the anterolateral approach rather than the conventional lateral approach in pinning of moderate and severe SCFE.

Adolescent↗

PubMedDate not supplied

Roentgenographic and mathematical analysis of first metatarsal osteotomies for metatarsus primus varus: a comparative study.

The operative effectiveness of five different first metatarsal osteotomies for nonarthritic hallux valgus and metatarsus primus varus were objectively evaluated roentgenographically. The series consisted of 120 feet (75 patients) seen over a 5-year period. The osteotomies were biplanar neck, Chevron, biplanar basilar, basilar concentric, and basilar concentric combined with a lateral closing wedge. All the osteotomies except for the Chevron had varying degrees of plantar displacement of the distal fragment and crossed Kirschner wire fixation. The operative techniques and failures are discussed. Special x-ray studies confirmed misleading pseudocorrections caused by bandage compression and intraoperative and early postoperative roentgenographic distortion. The Chevron gave the least correction, 2 degrees, and did not permit plantar displacement to obviate late metatarsal transfer lesions. The biplanar neck osteotomies were technically the simplest, giving 86% satisfactory corrections, averaging 4.3 degrees. The biplanar basilar osteotomies yielded the most erratic results. The poor results were due to medial tilt during fixation, thereby negating any correction. The technical difficulties with the basilar concentric osteotomy were overcome by the addition of a small lateral closing wedge. This procedure gave by far the most consistently good results with corrections of up to 12 degrees, averaging 7.9 degrees.

Adolescent↗

PubMedDate not supplied

[Lung function disorders in Sjögren's syndrome].

Pulmonary function tests were performed in 15 patients with Sjögren's Syndrome (SS). All patients presented with rheumatoid arthritis (RA) as well as with sicca syndrome. The mean values of residual volume, compliance and diffusion capacity were found to be abnormal. Vital capacity was abnormal in 40 percent of patients with SS, residual volume in 46 percent, compliance in 60 percent, and diffusion capacity in 66 percent respectively. The lung function was apparently affected more severely in SS than in rheumatoid arthritis. Thus in addition to the well known changes of lung function occuring in rheumatoid arthritis, progressing fibrosis might also contribute to a more extensive impairment of the lung function in SS. Although symptoms of chronic bronchitis and coughs were prevalent in our patients, obstruction was only observed in a comparatively small number.

Adult↗