C. Leslie Mitchell

Osteotomy-bunionectomy for Hallux Valgus

Over 400 operations have been done for hallux valgus with metatarsus primus varus in which a distal first metatarsal osteotomy with lateral displacement and angulation of the head was used. This operation was not done in patients who had simple hallux valgus without metatarsus primus varus.Fifty-nin

Congenital Dysplasia, Subluxation, and Dislocation of the Hip in Stillborn and Newborn Infants

Two hundred and forty hips in 120 stillborn and newborn babies were examined and dissected. The abnormal hips found included one hip with a superoposterior and one with anterior dislocation, three hips with superoposterior subluxations, and three dysplastic hips with the anatomical-pathological findings described and possible etiological factors discussed.

Fractures and Fracture—Dislocations of the Ankle

Accurate diagnosis and proper choice of treatment in fractures and fracture-dislocations of the ankle require a knowledge of the mechanisms of injury.Good x-rays, centered over the joint in true anteroposterior and lateral projections, are also prerequisites to accurate diagnosis.Closed methods of treatment may be used in many cases, but certain fractures require open reduction. Surgery must be precise, and, to allow the indicated correction to be made, x-rays should be taken in the operating room before the wound is closed.

Fracture of the femoral shaft complicated by hip dislocation; a method of treatment.

Dislocation of the hip, complicated by a fracture of the shaft of the femur, is an exceedingly rare condition and presents a most difficult problem in reduction. It is a well-known fact that this type of injury occurs in young and middle-aged adults most frequently, and is caused by only the most violent forms of trauma. For this reason, it is usually seen in a very muscular type of patient, which makes closed reduction even more difficult. The problem in reduction arises from the fact that the lever arm, the femur, is not intact and one has no control over the proximal fragment. The authors were able to restore the lever arm by means of the gas-pipe extension on the pin-fixation apparatus, and thus were successful in the reduction. The authors feel that non-union developed because of the excessive stripping of the periosteum from the proximal fragment, caused by the marked displacement resulting from the dislocation of the hip. The increase in density of the proximal portion of the shaft of the femur, probably due to the damage to the blood supply secondary to the periosteal stripping, is shown in Figure 5-A.

Non-osteogenic fibroma of bone; a review of the literature with the addition of six cases.

The clinical history and the roentgenographic and pathological findings in six cases of non-osteogenic fibroma of bone have been included in some detail in the hope that recognition of this lesion as a distinct entity will be made somewhat easier and that this diagnosis perhaps will be more frequently considered when tumors of bone, especially in the cortical metaphyseal region, have to be treated. Complete curettage or subperiosteal resection of the affected area is supported as the method of treatment.

The Surgical Technique for Hindquarter Amputation: A Report of 19 Cases

The surgical technique for hindquarter amputation is described in a step-by-step manner. Since 1955 we have performed 19 such operations for eradication of malignant bone and soft tissue tumors in the pelvic, hip and upper thigh regions. Three hindquarter amputations were performed for local recurrence following initial wide excision. The overall 5-year survival rate for our 19 patients was 42.1 per cent. Malignant soft tissue tumors appear to have a much better 5-year survival rate than malignant bone tumors (60 per cent vs. 22.2 percent). We feel that surgery is still the treatment of choice. However, in the presence of proper indications, chemotherapy and radiotherapy should be added to surgery in order to prolong survival time and save lives.

TEMPORARY OCCLUSION OF THE COMMON ILIAC ARTERY DURING HEMIPELVECTOMY

The surgical technique for temporarily occluding the common iliac artery during hemipelvectomy has been described. Not only can this technique significantly reduce the blood loss and operative time, but it may also minimize postoperative complications and increase the chances of a complete eradication of the primary malignant disease.