Faculty Bibliography

Four deformed feet in three patients were corrected completely using the new limited intervention technique of Ilizarov. One foot in the younger patient was corrected by soft tissue distraction only. In three feet in the older patients V osteotomies were needed to initiate the distraction. Two complications occurred: herpes simplex infected two of the osteotomy sites, which were treated successfully with local treatment. The detailed method and indications are outlined.

The results obtained in a study of 32 patients with 45 idiopathic clubfoot deformities treated by complete soft-tissue release between 1985 and 1986 were investigated retrospectively. The evaluation was based on a specifically designed functional rating system. The results were graded as follows: 51% excellent, 25% good, 18% fair, and 6% poor.

An angle within the femoral arch is defined, and its line is described in selecting the osteotomy site and the position of the fixation device in performing a femoral varus osteotomy. This neck metaphyseal angle was measured with varying degrees of rotation on seven pediatric femurs; it was also studied on 283 randomly selected hip radiographs. The angle varied 25-40 degrees in 90% of the patients and was not age related. The angle is stable within 5 degrees as long as the landmarks, base of the great trochanter, and medial metaphysis of the femoral neck are definable (0-30 degrees of rotation).

Primary skin closure after the surgical correction of severe club-foot may be difficult. We describe the use of a tissue expander to provide sufficient skin, and review some aspects of the use of the method

Fixation of the osteotomy site in the proximal femur is technically demanding. A new system, which includes cannulated chisels and a cannulated one-piece plate that can be inserted over a guide wire, is suggested. The new system simplifies the procedure and provides stable fixation

Sixty patients (eighty hips) who had slipped capital femoral epiphysis were treated by epiphyseodesis with a cannulated-screw technique. Forty-nine patients (sixty-seven hips) were available for follow-up, forty-four (sixty hips) of whom were followed for a minimum of two years. Thirty-five patients (forty-six hips) were followed until the hardware was removed. Of seventy-two hips in which contrast medium was injected, arthrographic results were obtained in three. In these three hips, there was evidence of pre-existing narrowing of the joint space. Four patients (six hips) who did not have evidence of penetration by a screw or guide-wire had evidence of either pre-existing chondrolysis or osteoarthrosis. Chondrolysis did not develop postoperatively in any patient who had no evidence of it preoperatively