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investigation, including exploration of the joint, it was found
that the bones could not be freed sufficiently to allow of
restoration of pronation and supination. She was discharged on
1.1.36.
In reviewing the patients from tbe Hornsey area who have
been treated in hospital, one finds that there are grounds for
a certain amount of satisfaction. In four cases the patient's
condition has been improved, and in one case (the girl age 6A)
it is safe to say that the child was completely cured. There is,
however, no doubt that a considerable part of operative
orthopfedic surgery is concerned with making the best of a badlydeformed
limb rather than with complete restoration of function.
The most encouraging part of the work today is the preventive
treatment carried out at the Clinic. The fact that only seven
patients out of 123 have been admitted during the year is in
itself encouraging.
To take one example of the value of Clinic work: large
numbers of children with knock-knees are seen at the Hornsey
Clinic, but they are being sent to us before the deformity has
become at all marked. It is not many years since operative
correction was frequently necessary for the cure of this condition;
it is now possible to deal with almost every case by alteration to
the shoes, exercises and sometimes the application of splints.
The need for operation has almost gone.
As the early manifestations of crippling diseases become
more widely known it is certain that severe residual deformity
will become increasingly rare.
H. J. SEDDON,
Orthopadic Surgeon.