Biomedical subjects
Publications and source records attributed to J M Fitton.
Epithelioid sarcoma is a rare and misleading lesion. It predominantly affects males and may occur in any age group. Two thirds of cases involve the hand. Four cases of this dangerous condition affecting the hand are described.
A new method of forefoot reconstruction for rheumatoid arthritis in 79 patients is described in which the metatarsal heads are preserved. The first metatarsophalangeal joint is fused and the bases of the proximal phalanges of only those rays involved with disease excised together with cysts and synovium. Post-operatively traction is used to maintain the length of the operated lateral toes. The results in 71 patients followed for 3-5 years after operation are reported. Excellent pain relief, improved stability and feet of normal length are achieved.
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Degeneration and disintegration of the accessory plantar ligaments occur in the absence of local inflammatory disease. The gross and histological changes are described. These lesions are associated with metatarsalgia, deformities of the metatarsophalangeal joints and the development of the convex anterior metatarsal arch. The connection between these three is explained.
A 13-year-old girl presented with a two-year history of pain in the right thigh and right forearm. Engelmann's disease was diagnosed on the basis of radiological appearances and histological examination of the bone. Her symptoms subsided after biopsy of the bone, but two weeks later she developed severe pain in the left tibia and was unable to walk. Radiological features of Engelmann's disease were found in the left tibia and other long bones although these bones had been radiologically normal one month previously. Treatment with prednisolone gave rapid relief of pain and allowed the patient to become mobile again. Four months later the radiological appearances showed significant improvement. The use of corticosteroids in this disorder is discussed.
Chronic instability of the ankle is frequently due to disruption of the fibres of the anterior talofibular ligament and the anterolateral capsule. This allows momentary subluxations at the ankle joint; the talus tilts into an abnormal varus position and rotates forwards and inwards about a vertical axis which passes through the medial malleolus. The use of a free tendon graft to reconstruct the anterior talofibular ligament restores the stability of the ankle without restricting movement at the subtalar level.
Operative correction of congenital vertical talus in nine feet in six patients is described. The operation consists of the comprehensive lengthening of the tendons in the foot and full peritalar release without excision of the navicular; it is performed through a dorsal transverse incision.
Eighty per cent of 63 patients who had undergone 136 surgical corrections of hammer toes in the 6 years prior to this study were improved by operation. In adults proximal phalangectomy was the most successful procedure to relieve symptoms and is suggested as the operation of choice. Flexor to extensor tendon transfer was successful in children but not in adults. It is proposed that the operation be performed in an out-patient basis whenever possible.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.