Biomedical subjects
Publications and source records attributed to F J Harvey.
A patient with osteomyelitis of the scaphoid in childhood resulting in a pathologic fracture with nonunion is presented. This ununited fracture of the scaphoid was successfully grafted eight years later with a satisfactory outcome.
We reviewed 21 patients with 22 ruptures of the extensor pollicis longus at a mean of 5.3 years after transfer of the extensor indicis proprius tendon. Of these, 19 with 21 transfers described the result as good, and two as fair. The mean deficit of extension between the operated and unoperated thumbs was 1.4 cm, and the mean flexion deficit 0.6 cm. Pressure gauge measurements showed that the strength of the transfer was 51% of that of the uninjured extensor. The two fair results had an extensor lag of over 1.5 cm. Independent extension of the index was maintained in all patients, none having a discernible lag, but the strength of index extension was reduced to 49% of that of the normal finger. There was no evidence of functional loss. Extensor indicis proprius transfer for rupture of the extensor pollicis longus tendon is a simple and reliable procedure with few complications. It gives satisfactory long-term extension of the thumb.
Congenital fusion of the carpal bones is fairly common and may be associated with other congenital deformities in the hand. This report deals with an unusual congenital anomaly of the little fingers associated with fusion of the triquetrum and lunate. Both little fingers were adducted and rotated giving crude resemblance to thumbs on the ulnar borders of the hands. The deformity was easily corrected by osteotomy through the base of the fifth metacarpals.
A new method of conservative treatment of Bennett's fracture is presented, the thumb being immobilised in moderate adduction rather than radial abduction. Anatomical dissections are outlined to demonstrate the rationale of this procedure.
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Intramedullary nailing of thirty acute displaced open fractures of the tibia and fibula resulted in union with only one superficial infection. The low incidence of sepsis is attributed to the use of the curved malleable Hodgkinson tibial nail which requires no reaming, renders the operation less difficult and traumatic, and interferes minimally with bone vascularity. Fibular nailing was an effective means of stabilizing nine of the twelve fractures close to the ankle joint.