494
EDITORIALS
At
times
attention
upon
unstable
hand
it is thought
cartilaginous,
bone
be
in
to
years
ago.
of children
been
designed
triple
to
appears
in the
Apart
which
and
from
no
and
ten
with
for
city,
in
its
The
bus
could
and
each
bus,
he
not
came
second
into
the
Although
support
value
little
of
there
a
contribution
is
demonstrable
lesion
by
type
muscular
it
damaged
by
In
papers
and
rupture
paper
where
after
in
cervical
the
minor
(when
this
; he
attended
a special
a mile
from
to and
from
his
bus.
put
was
of
home.
the
each
first
and
he
school.
morning
Leaving
on
the
gym
able
that
and
shoes.
to
cheer
be
used
the
is beyond
or
recently
This
of the
forcible
hyperextension
Blackwood,
and
the
We
then
that
believed
case
for
ligament
of
a series
and
no
of
the
view
Journal
without
that
is no
the
of the
writer,
cord
the
longer
tenable
cord
may
abnormality
described
injury
was
which
THE
OF
the
caused
go
BONE
disc.
In
his
injury
be
demonstrated
far
to
AND
by
revealed
hyperextension
could
experiments
be
neck.
intervertebral
a
cord
occurred
examination
from
JOURNAL
of correlation
of the
reduction
vertebrae
post-mortem
paraplegia
examination
that
present
the
lack
issue
accepted
and
ceased.
dispute.
paraplegia
it was
dislocation
by
this
traumatic
dislocation
a
The
MCFARLAND.
DISLOCATION
In
as
future.
is the
spine
of
violence
is no
longitudinal
describes
the
VERTEBRAL
mechanism
in extension,
fatal
should
assess
of others
injury.
Until
flexion
dislocation
then
They
to
cervical
vertebral
a transient
there
post-mortem
He
the
of a disc
a
while
of the
the
by
the
anterior
in it.
necessary
doubt
vertebrae.
when
reports
a thorough
spine.
and
child’s
a boy
the
school
kept
WITHOUT
on
injuries.
of the
Taylor
1934
journeys
irons
foot
to the
concerns
BRYAN
and
caused
Taylor
a transient
in
lesion
extrusion
of hyperextension
present
on
to
years
of injuries
cervical
was
even
mechanism
a complete
two
unstable
a stable
in
half
make
deformity
an
It
children
and
be
three
INJURY
immediately
that
often
also
remembered
to add
‘ ‘
group.
Taylor
of the
a massive
previous
It
with
him
splints
irons
home
back
should
or
latter
cord
of injury
clear
they
features
by
action
is now
to
boots
hurrying
two
CORD
of the
injury
in this
and
OF
severity
his
remains
puzzling
the
travelled
place,
is in the
MECHANISM
between
always
: give
about
the
had
discarded
by
the
operations
foot
most
so
arthrodesis
be
a child
moral.
‘ ‘
was
to take
a subsequent
calcaneus
Association
its
wore
school
the
have
disturbed.
it must
can
our
without
bus
and
day;
their
during
surgical
of the
his
want
He
to
on
They
way.
have
of the
One
quickly
of
its
protection
some
Stabilisation
the
a small
children
Nor
Orthopaedic
legs.
been
use,
a caliper
not
is not
both
patient
house,
splints
and
the
do
British
children;
Our
high-spot
on
the
described)
provided
all
the
bus-load
to
we
with
out
.
subsequent
structural
soleus.
dispense
all,
affecting
hold
evening.
went
told
their
and
and
not
twenty
bony.
against
postural
gastrocnemius
first
defective
becomes
reasons
After
has
or
a
burden
it
earlier)
growth
radical
to the
carried
arise
has
growth
ankylosis
progressive
to
instances
and
knee
not
prejudice
few
less
adopting
been
does
growing
should
suitable
since
accordingly
need
with
in addition
‘ ‘
one
largely
operation
by
policy
operate
the
are
interference
iron
‘ ‘
to
On
which
stabilising
possible
this
have
(the
economic
all.
paralysis
regret
which
point.
bones
the
less
of an
to
recurred
of the
benevolence,
burden
without
fibrous
of the
story
physically
The
not
the
were
a six-year
school
Then
‘flie
a full
upwards
stable
and
at
that
nature
age
of time
appliance
and
that
at
this
tarsal
recur,
the
age
on
it is true
surprisingly
has
control
procedure
cause
In
paralysis
in life.
policy
foot
prevent
muscular
need
handicap
the
sentimental
will
poor
will
of
course
appliance
results
foot
he
from
no
the
no
best
centred
between
it is none
carries
had
years
Deformity
that
that
child
arthrodesis.
necessary.
consequently
feet,
of the
again
occur
a conservative
five
render
stabilising
been
of
from
question
have
cannot
children’s
no
the
While
I have
Operations
feet
may
that
Certainly
to
fusion
deformity.
little
ensure
paralysis.
bony
cause
on
given
discussions
deformity
itself
performed
operations
of
been
lately
that
that
may
not
has
and
feet,
JOINT
prove
that
SURGERY
EDITORIALS
the
cord
canal
injury
when
not
so,
of
that
long
been
known
and
those
that
cervical
spine
incipient
hyperextending
by
this
may
this
reason
cord
be
is the
evidence
of
vertebral
contused
by
a massive
evidence
may
problem
is not
an
head
does
in
cause
further
as
injury
of the
position,
which
bulging
cannot
of the
to
forehead
cause
further
interlaminar
JOINT
A
joint
held
in
of
British
war,
we
VOL.
and
and
nation
met
of
hope
33
meeting
in
the
American
again
the
to
B,
of
London
with
THE
the
them
4,
NOVEMBER
NO.
as a result
Taylor
week
the
surgeons
world
all.
1951
and
It
has
of
any
changes
Surgery,
in
18,
osteoarthritis
893)
of
a partial
spinal
sound
the
block
reasons
of
the
ligament
for
neck
is
behind
and
should
whom
there
is no
only
cause.
The
the
of
immobilise
cord
by
slight
an
injury,
to
kinking
extruded
the
and
of the
the
neck
OF
THE
OF
Associations
of
vertex
in
a disc
will
be
of the
the
neutral
protrusion
or
BARNES.
AMERICA
of
1952-thus
the
English-speaking
fulfilling
who
Canada
often
COMMONWEALTH
STATES
surgeons
The
will
ORTHOPAEDIC
BRITISH
of July
This
disc.
patient
over
caused
flexion.”
ROLAND
THE
For
without
as injuries
in
over
injury.
paraplegia
regarded
examination
is safe
to
of
immobilisation
careful
it
the
be
if it is kinked
doubt
in
it is not
“cases
cord
for
patients
of a hyperfiexion
that
the
UNITED
orthopaedic
English-speaking
honour
in
by
Orthopaedic
first
absence
injuries
But
such
MEETING
AND
be
paraplegia
dislocation.
damage
OF
the
therefore
ligament.
ASSOCIATIONS
adult
arthritic
that
are
If it
hyperextended.
a young
Joint
to
and
in a hyperextension
in
in
and
as
appears,
If
usual
vertebrae.
interlaminar
or displacement
or
injury.
in
advanced
neck
bulging
with
treated
it
is the
considerable
was
cervical
hyperextension
protrusion
agree
as
face
with
Bone
There
of
or
disc
damage
difficult
a hyperfiexion
cause
damage
spinal
to injury.
adult
secondary
in
the
injury
and
the
in front.
usual
not
of bone
hyperextension
position
reveal
writer
this
demonstrated
osteophytes
of
manoeuvre.
osteophyte
this
that
injury
by
the
between
or adjacent
a young
paraplegia
paraplegia
trapped
that
the
forcible
that
being
disc
radiographic
by
complete
Taylor
of
in a patient
by
suggestion
into
susceptible
of the
(Journal
of
is likely
cord
cord
Morton
symptoms
the
radiographic
the
cord
for
neck
compressed
aggravated
degenerate
It
be
for
indeed.
the
osteoarthritis
the
made
by
may
of safety
small
Taylor’s
caused
cord
bulging
suggests
a hyperextension
advanced
were
sometimes
accepting
the
the
complicates
have
also
render
catastrophe,
when
seldom
ligaments
He
which
a common
afflicted
be
interlaminar
injuries.
factors
ligaments
margin
may
the
hyperextended.
other
be
that
the
neck
observed
by
might
by
in hyperextension
be
paraplegia
of
caused
lesion
interlaminar
most
the
forcibly
this
the
know
was
was
cord
however,
that
the
neck
must,
bulging
injury,
was
the
of
There
We
case
the
mechanism
were
in his
495
met
after
represented.
in
the
the
London
second
\Ve
will
hopes
after
war.
welcome
world
and
the
This
them
will
aspirations
first
world
time
every
all;
and