Surgical treatment of displaced supracondylar fractures of the humerus in children. Analysis of fifty-two cases followed for five to fifteen years

Long-term review of fifty-two displaced supracondylar humeral fractures in children treated by open reduction and crossed Kirschner-wire fixation demonstrated functional results similar to those obtained by closed methods, but fewer and milder cases of cubitus varus deformity (only 25 per cent of patients). The deformity appeared to result from faulty reduction with medial angulation of the distal fragment. Surgical treatment of these fractures may offer, as its principal advantages: reduced hospitalization time, fewer sequelae, more stable fixation, and slightly better anatomical results. No infections or other specific complications (such as myositis ossificans or Volkmann's contracture) were encountered.

Keratosis follicularis spinulosa decalvans. An infant with failure to thrive, deafness, and recurrent infections

A 10-month-old male infant had keratosis follicularis spinulosa decalvans, an X-linked dominant disorder. His cutaneous abnormalities consisted of generalized hyperkeratosis, spiny follicular papular lesions, universal alopecia, and hypoplastic nails. Ocular changes characteristic of the disease were also present. Unusual findings included deafness, failure to thrive, predisposition to bacterial infections without demonstrable immune defect, and transient hepatomegaly with abnormal liver function studies.

[Osteotomies of the forearm in the treatment of ulnar dysmelia (author's transl)]

The syndrome and classification of ulnadysmelia--which shows considerable analogy to fibuladysmelia--is described on the basis of two cases. The therapy of the milder form of this deformation which includes our two patients is discussed. Correction osteotomy of the bones of both forearms with excision of the radial head is recommended for inveterate cases. In younger children, a result which is both cosmetically and functionally successful can be achieved by lenghtening osteotomy of the ulna. The operation is to be repeated if necessary.

Occlusive phlebitis in multifocal fibrosclerosis

Multifocal fibrosclerosis, as the name implies, concerns disseminated fibrous processes that manifest as Riedel's thyroiditis, idiopathic retroperitoneal fibrosis, mediastinal fibrosis, sclerosing cholangitis, and pseudotumor of the orbit. Certain cases of fibrosis of the parotid gland, the lacrimal glands, and the lung may belong in the same category. The cases of two patients with Riedel's thyroiditis, one of whom also has retroperitoneal fibrosis, are described. Unusual changes in the small and middle-sized veins in the fibrous tissue in the thyroid and in the retroperitoneum, best designated "occlusive phlebitis," seem to be characteristic of the multifocal fibrosclerosis. They may contribute to the disease process.

The treatment of infected non-union of fractures of long bones. Study of sixty-four cases with a five to twenty-one-year follow-up

The result of treatment of sixty-four patients with infected ununited fractures of long bone by debridement of soft tissue and bone and open suction-irrigation drainage, followed by rigid stabilization of the non-union and cancellous bone-grafting when indicated, was bone union in sixty cases, even in the presence of infection. The late results five to twenty-one years later showed good function despite the fact that prolonged periods of hospitalization were often required. The importance of local treatment of the infection prior to stabilizing the fracture fragments, and the use of cancellous bone grafts when necessary, are emphasized.

A new mucolipidosis with psychomotor retardation, corneal clouding, and retinal degeneration

A 23-year-old man had slow psychomotor development at 6 months of age and developed intermittent corneal clouding at about 18 months. He developed a truncal ataxia and hypotonia of the limbs combined with spasticity and active deep reflexes that did not progress. His skeleton and facies were normal. Between 1 and 13 years of age, he developed severe optic atrophy, absence of retinal blood vessels, and an extinguished electroretinogram. Biochemical analysis of cultured fibroblasts indicated no lysosomal hydrolase deficiency; cellular metachromasia was absent and there was no mucopolysaccharidoses. Ultrastructural studies indicated single-membrane-limited vacuoles containing lamellated membranes and a polymorphous substance in tissue-cultured cells and conjunctiva.

The educational process as a treatment modality in a drug rehabilitation program

The authors describe an eductional program that is an integral part of a residential drug rehabilitation program. They believe that effective treatment of drug addiction must provide individuals with the opportunity to acquire skills that will make it easier for them to compete in the job market when they leave the program. They discuss how the educational process serves as a treatment modality that supplements and complements the other aspects of the therapeutic community.

A new mucolipidosis with psychomotor retardation, corneal clouding, and retinal degeneration

A man now 22 years of age had slow psychomotor development about 6 months after birth and developed intermittent corneal clouding at about 18 months. He developed truncal ataxia, hypotonia of the limbs combined with spasticity, and active deep reflexes. These have not progressed. His skeleton and facies are normal. Between his first and thriteenth year he developed sev ere optic atrophy, absence of retinal blood vessels, and an extinguished electroretinogram. Biochemical analysis of cultured fibroblasts indicated no lysosomal hydrolase deficiency; cellular metachromasia was absent and there was no mucopolysaccharidoses. Ultrastructural studies indicated single membrane vacuoles containing lamellated membranes and a polymorphous substance in tissue cultured cells and conjunctiva.

Results of therapy in adult acute lymphocytic leukemia

27 adult patients with acute lymphocytic leukemia have been analyzed. Complete remission was induced in 9 of 113 patients treated with prednisone +6-MP, 4 of 6 patients treated with prednisone + vincristine, and the one patient treated with a combination of prednisone, vincristine, 6-MP, and methotrexate. The median survival for these 20 patients was 11 months and the median duration of complete remission was 71/2 months. Two of these patients remain in complete remission at 8+ years. Our most recent regimen for remission induction, prednisone + vincristine + daunomycin, has produced complete remission in 7 of 7 patients, with a median duration of complete remission of 15 months. Three patients remain in their original complete remission from 16+ to 24+ months, and 5 of these 7 patients remain alive from 16+ to 24+ months.