Spinal lesions in battered babies.

The case histories of five young children are presented to demonstrate the radiological appearances of trauma to the spine thought to be the result of maltreatment by either parent or guardian. Four of the children were admitted to hospital within a period of three years, all being under the age of two years.

Meniscectomy.

Meniscectomy will predispose to degenerative osteoarthritis. To reduce the incidence of long-term morbidity the removal of normal menisci must be kept ot a minimum. The value of arthrography and arthroscopy in establishing a diagnosis and reducing the incidence of arthrotomy, is well recognised. Arthrography and arthroscopy are complementary and in many diagnostic knee problem both are indicated.

Early experience with total knee replacement.

This paper presents a review of two years' experience with the geometric total knee replacement. The results of 23 arthroplasties in 22 patients are discussed. Relief of pain was consistent and dramatic, movement was increased postoperatively in only three patients, but imporvement in overall function occurred in 20 of the 22 patients. There was one failure requiring arthrodesis. In this patient, six months after surgery the medial tibial condyle collapsed and the polyethylene tibial component fractured. This complication has not been reported before. Early results are encouraging. Total knee joint replacement is a useful procedure in advanced arthritis when arthrodesis is the only alternative.

The effect of dried mussel extract on an induced polyarthritis in rats.

A polyarthritis was induced in a number of rats by the intradermal injection of a modified Freund's adjuvant into the right foot pad. Powered extract of New Zealand mussel fed to the rats did not have any beneficial effect on either the development or the severity of the arthritis.

Coping, satisfaction, and the life cycle in families with mentally retarded persons.

The study focused on the variables influencing the functioning of 62 families with MR (mentally retarded) persons, living at home, in various stages of the life cycle. Results demonstrated the importance of some father characteristics to maternal coping skills in two-parent households. Although mean maternal coping scores were not statistically different between two-parent and single-parent households, single mothers' coping skills showed strong negative associations with both the number of children in the household and the age of the mother. This was not true of mothers in two-parent households. Single-parent mothers also appeared to be considerably more dissatisfied with family functioning than mothers in two-parent households. The supportive role of older fathers in mothers' coping in two-parent households also was apparent. Clinical implications of the study point to the need for greater support for mothers of young children with MR, mothers who are sole caregivers, and parents with many children. Differential support to mothers and fathers of an MR person may be required over the life cycle.

Using videorecordings in pediatric nursing practice.

This article explores the innovative uses of videorecordings in pediatric nursing practice. Social learning theory and primary nursing concepts provide the conceptual orientation. Creative uses of videorecordings include: enhanced family education; continuity of care through caregiver modeling and staff communication; audiovisual progress recording; and potential behavioral development in the pediatric client. Suggestions regarding technical aspects of videorecordings in the clinical area may facilitate videorecording application.

Perioperative nursing. Designing, implementing a baccalaureate elective.

The clinical faculty of the affiliated teaching hospitals felt the initial course offering was beneficial to students and institutions alike. The course served as a foundation for the students' entry into perioperative nursing practice, and served to shorten the amount of time institutions invest in orientation. In conclusion, we recognize the importance of offering a perioperative nursing educational opportunity at the baccalaureate level. With increased student interest, we are looking forward to continuing the course and implementing the refinements as recommended.

The use of methylmethacrylate in the treatment of giant cell tumours of the proximal tibia.

Two cases of giant cell tumour of the proximal tibia are presented where the defect remaining after curettage has been filled with methylmethacrylate bone cement. The problems associated with the present management of giant cell tumours and the potential advantages of using methylmethacrylate are discussed.

A scanning electron microscopic study of wear in the plastic components of prosthetic knee and hip joints.

The polyethylene surfaces of four metal on plastic prosthetic knee joints were compared with those of four hip joint replacements, by the use of scanning electron microscopy. The acetabular components of the hip joints showed concentric machining marks, but were generally smooth, and in some areas plastic deformation of the articular surface was evident after 24 months' use. In contrast, the tibial components of knee joints removed after 12 to 22 months showed deep scoring and pitting near the centre of their articular surfaces. This appeared to be due to abrasion by a third material, possibly fragments of cement, which sometimes became embedded in the joint surface. These results indicate that wear in prosthetic knee joints may be much more rapid than in hip joint replacements made from similar materials.

Orthopaedic training in private practice.

The background philosophy, structure and training experience offered by a new free-standing clinic set up purely to facilitate orthopaedic post-graduate training is described. Emphasis is placed on the ethical issues involved. The educational programme, which includes involvement in all local and national activities, is summarized. The registrars' operative experience is recorded using log-sheet criteria. This venture has predated the major restructuring of the health care system in Auckland, which is anticipated in the next few years, and will therefore allow the training programme to evolve appropriately, employing the educational opportunities of all sectors of health care.