Abstracts 247

(SANDERSON M. C. (1975) Amt. N.Z. J. Surg. 45, 40) Recreational injuries Ski injuries in the USA on different forms of treatment. Those with conserva-

tive treatment had 83 per cent good to excellent recovery. Of those whose patellas were excised, 64 per cent did well despite some loss in power. Those with internal fixation resulted in only 55 per cent satis- factory response. Sanderson concluded that should there be doubt about treatment, then patellectomy would be the treatment of choice despite some inevitable loss of power.

EDITORIAL (1975) Br. Med. J. 3,447.

There are 5 million skiers in America with an injury rate of 5 per 1000 skiing days. Such is the estimate of Dr Gutman who analysed 792 skiing injuries in the 1972-3 season in Vermont, and compared the stat- istics with those of the 12 years previously. Sprains accounted for nearly half of the injuries in both series. Ankle sprains were common in 1961, but the upper limb was more often involved in the later group. Likewise half the fractures in 1961 were situated in

Traumatic dislocation of hip in children the ankle, whereas in 1973 this figure had dropped to 20 per cent, and there were three times as many

This condition is not common: a total of 409 cases fractures in the uouer limb in the later series. have been reported in the literature. In 13 of these

review of the reported cases and describes 600 addi-

patients the dislocation had recurred. The dislocation

tional cases, one of which recurred after minor trauma. The most common complication is ‘caput necrosis’

is almost always posterior. This paper presents a

which occurs in 5-30 per cent depending on the age. The incidence is higher in older children. The correct treatment is closed reduction followed by a brief period of immobilization. Fracture of the posterior lip of the acetabulum is a rare complication. When present, open reduction and internal fixation may be

increase of injuries i% the more skilled skier and explained this on the basis of improvement in speed and a tendency to take more risks.

The author finds this change in the pattern of ski injury to be due to the use of hard plastic boots which protect the lower leg. The author also found an

GUTMAN J., WEISBUCH J. and WOLF M. (1974) Ski injuries in 1972-73. JAMA 230, 1423.

Hang glider injuries The first report on injuries received by hang gliders includes 4 fatal cases and 8 serious non-fatal ones.

necessary to restore stability. HOVELIUS L. (1974) Traumatic dislocation of the hip

outlines the factors responsible and suggests preven-

in children. Acta Orthop. Stand. 45,746. tive safety measures. There are an estimated 10,000 participants in the United States in this new high-risk

Degenerative disease of hip In a review of total hip replacements at one hospital, 80 cases were noted in which degenerative arthritis had been caused by injury, for example fractures of the neck of femur or acetabulum. The treatment, results and complications are described.

WELCH R. B., TAVLOR L. W. and WYNNE G. W. (1975) Total hip replacement as a salvage in traumatic lesions about the hip. Surg. Gynecol. Obstet. 140, 708.

Fracture-dislocation of the tarso-metatarsal joint Nine cases of fracture-dislocation of the tarso- metatarsal joint are presented and these vary in major details from simple dislocations due to head-on collisions in car accidents to ones where weights have fallen on the foot, and there are fractures involving the shafts of the metatarsal also. They recommend an operative approach, fixing the fracture with Kirschner wires temporarily, and had reasonable results in these cases. whereas in conservative management results

sport. Novices who become airborne by running down hill do not get seriously injured. Major injuries occur in launches from cliffs and mountains. Faulty judgement seems to be the commonest cause of serious injury, but there was one fatal accident due to the use of hallucinogens and one caused by equipment failure. Among the many suggestions for the pre- vention of hang glider accidents are special clothing and the use of helmets and ankle top boots.

KRISSOFZ W. B. and EISEMAN B. (1975) Injuries associated with hang gliding. JAMA 233, 158.

Treatment of sunburn Topical application of indomethacin dramatically reduces redness and pain of sunburn. This is the claim of dermatologist Dr Snyden from Miami made to the American Academy of Dermatology meeting in Chicago. She used a simple organic solution of 2.5 per cent indomethacin. Similar results were obtained with 450 mg of neutralized aspirin injected intradermally. Both these drugs work by inhibiting enzymes that synthesize prostaglandin. These claims are based on

have’ been disappointing. In late &es, primary tests with 30 animals and 25 humans.

tarso-metatarsal arthrodesis is suggested, especially SNYDER D. (1974) Prostaglandin inhibitors heal sub-

when the joints are badly damaged. Simple dislo- burn. JAMA 227,386.

cations without fracture are better treated conserva- tively and are mostly reduced without too much difficulty, though the foot is certainly stiff at the mid-

Pathology and experimental work

tarsal joint afterwards. The myofibroblast RINALDI C. A. (1975) Operative treatment of As well as normal fibroblasts in hypertrophic scars,

fracture-dislocation bf the tarso-metatarsal joint. contractile fibroblasts are recognized. There is some Minerva Ortopedica 26, 323 (Italian). evidence that they could play a part in scar contraction