Cyclops : Case report

A para iv, having an uneventful prenatal course, spontaneously delivered a stillborn cyclopic monster. The important pathological findings were a single median eye above which was a median proboscis. Radiographic findings revealed a microcephalic skull containing one large orbit located in the median line.     

Acetabular Reconstruction With Chiari Pelvic Osteotomy : Report of 2 Cases

We performed cementless total hip arthroplasty combined with acetabular reconstruction with Chiari pelvic osteotomy on 3 hips in 2 patients. This procedure increased the osseous coverage of the shell and decreased the load around the hip by medialization of the hip center. Osteosynthesis of the proximal and distal bone fragment was performed using a shell with screws. Nonunion between the proximal and distal fragments was not noticed to include the case with small contact area. Postoperative dislocation had not occurred in these cases as of 1 year after surgery. This method may be an effective solution for severe dysplasia and revision surgery.     

Composite Reconstruction of the Hip Following Resection of Periacetabular Tumors : Middle-Term Outcome

The records of 18 patients with periacetabular tumors who underwent composite reconstruction of the hip following resection of periacetabular tumors were analyzed retrospectively. The mean follow-up period was 49.4 months (range, 28–100 months). During follow-up, 3 patients died and one had recurrence. Fifteen patients achieved favorable walking function; 8 had normal hip function and 7 had partial recovery of flexion function of the hip. The mean MSTS rating for hip function was 76.9%. Two patients had common peroneal nerve injury which was resolved in one of them. Middle-term follow-up showed that composite reconstruction of the hip following resection of periacetabular tumors can effectively remove tumors and provide favorable hip function for these patients. This approach is simple and less costly, and can be widely used.     

Gastric cancer : Contemporary aspects

Records of 403 patients with gastric cancer seen between 1957 and 1966 at the Lahey Clinic Foundation have been analyzed. While the operability rate was 94 per cent and the resectability rate was 58 per cent, the cure rate was only 11 per cent and was unchanged from the previous decade. Significant correlation occurs with location, clinical type, histologic type, size of tumor, and number of lymph node metastases. The surgical approach is aggressive in exploration and in treating extensive but resectable cancers but is conservative for the average cancers and does not include resection of spleen, omentum, pancreas, and total stomach if possible.     

Squeaking Hip Arthroplasties : A Tribological Phenomenon

The clinical incidence of squeaking has been reported with increasing frequency, with ceramic-on-ceramic bearings seemingly most affected. This study investigated potential causes of squeaking in hard-on-hard hip bearings through 2 sets of experimental conditions. Bearing clearance appeared to affect the incidence of squeaking in metal-on-metal surface arthroplasties. The addition of third-body particles to the interface for total hip arthroplasties also affected the incidence of squeaking. In both studies, the incidence of squeaking correlated well with elevated friction. The findings of this study suggest that a likely cause of squeaking in the hip arthroplasty is adverse tribological conditions caused by suboptimal lubrication. There are numerous factors that may cause the suboptimal lubrication, and therefore, it is unlikely that an individual cause for squeaking will be identified.     

Pseudoperitonitis : Due to external traumatism

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1. The type of case with which this paper deals is one which demands the minutest and most painstaking personal care of the surgeon himself.     

Low rectovaginal fistulas : Approach and treatment

Experience with thirty-two patients with a low rectovaginal fistula with or without attendant sphincter damage is reported. The technic used is advancement of the anterior rectal wall with excision of the infected anal glandular tissue and repair of muscle tissue when indicated. Anorectal infection and childbirth injuries were the common causes. An acceptable recurrence rate was achieved. Colostomy was not used in this series.