A new open reduction treatment for congenital hip dislocation: long-term follow-up of the extensive anterolateral approach.

Congenital hip dislocation, which is conservatively unmanageable, has usually been treated using open reduction. However, a long-term follow-up study of the results suggests that this procedure is unsatisfactory. Since 1973, Tanabe has used a new open reduction procedure that circumferentially dissects the joint capsule and produces sufficient concentric reduction of the femoral head in the acetabulum immediately after the surgery. Fifty-six children (65 hips) from the age of 1 to 3 years were treated by this procedure, and fifty-one of them were clinically and roentgenographically followed up from 6.3 to 12.4 years after the surgery. At the final follow-up session, all children had grown to be over 9 years of age, and no patient had clinically significant symptoms. According to Severin's classification, 33 hips were rated in Group I, and 14 hips in Group II. Another 10 hips were in Group III, and one hip was in Group IV. The incidence of avascular necrosis was 5.2 per cent. These data suggest that our procedure is more useful than the previous ones

Unique features of monoclonal IgG2b in the cleavage reaction with pepsin.

Preparations of IgG2b purified from several mouse hybridoma clones were highly susceptible, compared to other subclasses, to peptic digestion under conditions usually used to prepare F (ab')2 fragments. Analyses of the digestion products revealed that no F (ab')2 was produced and that the main product was a Fab-like fragment. Demonstration of the hinge disulfides in the Fc portion clearly indicated that in IgG2b the primary peptic cleavage occurs on the NH2-terminal side of the inter-heavy chain disulfide bridge. The resulting Fab failed to bind with antigen, suggesting the importance of the CH1-hinge region in maintaining the native conformation of the antigen-binding site.</p

Operative treatment of congenital muscular torticollis: long term results of myotomy

Myotomy was performed in 40 patients under 10 years of age with typical congenital muscular torticollis. Follow-up studies were carried out on 29 out of 40 cases. The patients without muscle relief of the affected sternomastoid muscle after myotomy had good range of motion of the neck. On the other hand, the patients who had undergone muscle release had, to grater or lesser extent, disturbances of the range of movement. For complete release of contracture, total excision may be the only operation in younger cases