[Errors in the radiological diagnosis of injuries of the cervical spine (author's transl)]. / Fehlbefundung in der Röntgendiagnostik der Halswirbelsäulenverletzungen.

The frequency of fractures of the cervical spine has increased with the rise in traffic accidents, but the radiological diagnosis of fractures at the initial examination remains unsatisfactory. A false negative diagnosis in the accident department was made in 25 out of 86 patients (29%) by a surgeon and in 12 patients (14%) by a radiologist. Poor radiographic quality was an important source of error, particularly for the diffult fractures in the cranial and caudal parts of the cervical spine. Half the fractures of the arch of the atlas and of the odontoid were missed initially. There was also difficulty in diagnosing fractures of the articular processes, evulsion fractures of the vertebrae and unilateral subluxation. Since the late results of missed vertebral fractures may be fatal, it is necessary to make more use of those signs which may indicate a fracture. Widening of the pre-vertebral soft tissues was seen in 33 out of 100 patients and an increased distance between articular facets on the A. P. projection in 19 out of 100 patients. Angled A. P. projections are useful for the diagnosis of fractures of articular facets in bed-ridden patients. Fractures in the lower cervical spine are well seen on oblique supine views. In larger accident departments, tomography and immediate radiological consultation should be available.

[Direct pernodal lymphography (an alternative technique) (author's transl)]. / Direkte pernodale Lymphographie bei Kleinkindern (Eine andere technische Möglichkeit).

A lymphographic technique via direct injection into superficial inguinal lymphnodes is described which has proved useful in infants.

Experimental osteotomy fixed with composite resins.

In connection with osteosynthesis carried out on the tibias of rats we compared acrylic and bis-GMA plastics (CMW and Silar) and acrylic emulsion and acrylic dispersion used as intermediary material. A total of 80 rats of both sexes were used. The rats were divided into four groups, in which different intermediary material combinations were tested. The observation times were 1, 3, 6, 12, and 24 weeks. Macroscopical, radiological, histological, oxytetracycline fluorescence, and scanning electron-microscopical studies were done. Histologically, the Silar proved to be the more reliable fixation material and acrylic dispersion the better intermediary material. Furthermore, the radiological results were better (P less than 0.05) when acrylic dispersion was used as the intermediary material and Silar as the plastic.

Calcification in cervical arteries in life and at autopsy.

In the clinical part of the study routine neck PA radiographs taken with the mouth open were compared with soft tissue films with the mouth closed for detection of calcification in the carotid arteries. Only 5.5% of 90 hospitalized patients showed foci of calcification in routine films. But foci of calcification were seen in 22% of the soft tissue radiographs of the whole series. In the autopsy part of the study large foci of calcification were found at the carotid bifurcations in 12 out of 20 cadavers by radiography. In an additional five cases contact radiographs also showed smaller foci of calcification. The vascular endothelium over the calcification was often ulcerated. The significance of the large arterial foci of calcification demonstrated in the neck radiographs as a sign of atherosclerosis and as a source of cerebral thromboembolism is discussed.

Glassy carbon implant as a bone graft substitute: an experimental study on rabbits.

The purpose of this experimental investigation was to study the incorporation of porous glassy carbon in bone. Cylinders of porous glassy carbon were implanted in drill holes in diaphyses and metaphyses of rabbits tibia for 1, 3, 6, 12 and 24 weeks. Bone ingrowth into the glassy carbon implants was examined by radiographic, histologic, fluorocrome and microradiographic methods. The material caused no pathological reaction. Tissue ingrowth into pores was seen by all examination methods. The amount of bone in the pores increases with time. The ingrowth was most distinctive in those areas where the implant was in close contact with cortical bone or trabeculae of the cancellous bone. Porous glassy carbon can be used as bone substitute, although the small size of implant available is at the present a limitation for its clinical use.