Total ankle arthroplasty. A procedural review.

Total ankle arthroplasty is a demanding surgical procedure, but the advantages of maintaining motion in the tibiotalar joint in the patient with systemic arthritis are known. Although the technology of ankle implant arthroplasty is still evolving, current results in properly selected patients approach the results of other leg implants.

The Canton Asylum for Insane Indians: an example of institutional neglect.

Based on archival data, the author chronicles the history of the Canton (S.D.) Asylum for Insane Indians, which was established by Congress in 1903 and was closed in 1934 because of inadequate conditions. In 1926 a nationwide survey found that patients at Canton received minimal care. The rates of patient death and discharge at Canton reported in a 1931 survey compared unfavorably to those at other mental institutions in the U.S. The 1929 and 1933 inspection reports of psychiatrist Samuel Silk, which documented the hospital's outmoded custodial care and questioned the necessity of institutionalization for 35 to 40 of Canton's 90 patients, played a key role in the decision to close the asylum. The author attributes the decline of the Canton Asylum to gradual neglect by its superintendent and various government agencies.