Biomechanics and biomaterials of bone, joints, and implants has been presented in an overview manner with the use of selected examples. The musculoskeletal system is a living, dynamic entity that is constructed so that changes in mechanics, if the body does not have time to compensate, can lead to major problems over a period of time. The mechanics of the tissues ensure a smoothly operating system.
This is a preliminary report of eleven patients with painful total joint arthroplasties. In their evaluation the difficulty in the differential diagnosis between the loose and the infected total joint becomes apparent. We have found the use of differential bone scans an accurate method to identify the infected total joint. Further study along these lines is indicated with a larger series and generalization to other types of implants.
A female patient with a recurrent synovial sarcoma of right 1st toe (35 years) after the first operation is presented. The histology of the tumor 35 years ago showed evidence of the biphasic structure, while the recurrent tumor contained only the fibrous elements. The patient has been examined 3 years after the last operation. She has no pain and there is no evidence of any recurrence. The patient refuses any radiation or additional surgery at this time.
Extremely painful paresthesias and mild motor weakness of the hand were relieved by sectioning the deep head of the pronator teres muscle and the fibrous arch of the flexor digitorum superficialis, thereby freeing the median nerve and its anterior interosseous branch. The characteristic pinch deformity of the thumb and index fingers usually described in anterior interosseous-nerve syndrome was not present. A Tinel sign at the level of the pronator teres was present.
The aetiological role of immunodeficiency in acute septic arthritis of the hip in infancy, the management of the condition after the acute infection has subsided, and the special hazards of infection in the region of the hip joint in the older child are discussed. The principles of treatment of congenital dislocation of the hip are examined in relation to the maintenance of acetabular growth potential. The factors determining the outcome of treatment in Perthes' disease are discussed and a comparison of the result in a series of cases treated by femoral osteotomy with those in untreated controls is presented.
Fractures of the distal phalanx of the hand occur usually by crushing can be irreducible, if the nail fold is interposed between the fracture fragments. Details of the regional anatomy producing the deformity and the management are discussed.
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