Dissection of the neck after intensive irradiation to the neck; its feasibility in the management of cervical metastasis from oral cancer.
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The bone alterations in the region of the clavicle (3 cases) are similar to those we have observed and described elsewhere in the skeleton i.e., the mandible, maxillary and ethmoid bones. Rarefaction is the result of three different types of bone destruction: osteoclasia, a kind of osteocytic osteolysis only observed after irradiation and obviously related with infection, and a pure demineralization of the osseous tissue by contact with pus. Reconstruction processes, although unable to prevent spontaneous fracture, are also present and correspond to islets of chondroid tissue surrounded by lamellar bone. However, these recently deposited calcified tissues are already necrotic since most of their lacunae are empty.
In the industrial countries, the number of hip fractures will double or even triple in the next 20 years. Pathogenetically, it is a complex matter of medical as well as biosocial factors. Gerontoprophylactically, it is more a biomechanical problem. Therefore a light fall on to the hip at the greater trochanter is of the greatest importance. We have constructed an impact neutralizer, also designed as a hip fracture bandage, to absorb the impact forces which act on aged people during a fall. It is made of a special silicone rubber. The impact neutralizer permits an impulse amplification by a factor of approximately two. Also, the critical height of the fall is increased by a factor of three. That means that the number of hip fractures occurring in elderly people can be reduced by 30-50%, depending on the type of fall and assuming that all elderly people liable to fall wear the hip fracture bandage.
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