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51
I am indebted to Mr. J. A. Cholmeley, F.R.C.S., for the
following report on the work of the Orthopaedic Clinic:—
During the past year there have been certain changes and
difficulties at the Orthopaedic Clinic. Mrs. Yorke, who had been
the physiotherapist for several years, left, as she had an opportunity
to do similar work nearer her home and for some while it was found
impossible to get anyone to replace her. In the early part of the
year a considerable increase in the number of surgeon's sessions
at the orthopaedic clinic and the opening of additional clinics over
the County made it quite impossible for me to carry out increased
clinic work so that I had to discontinue my attendances at Tottenham
and my work was taken over by Mr. J. I. P. James, M.S., F.R.C.S.,
in September.
Examining the returns of the Clinic for the past five years it
will be noted that apart from 1945 there has been a steady increase
in the number of new cases examined each year; however, in 1946
there has been a decrease in the number of cases treated and the
number of treatments given, almost certainly due to the time when
there was no physiotherapist available.
The detailed schedule of new defects shows an almost steady
number of congenital abnormalities each year, but the number of
cases of Flat Feet and Knock Knees has increased steadily. In
the case of the former this is certainly in part at least due to the poor
type of shoes, available for children, but in the case of the latter
the increased number is probably due to the tendency when a specialist
clinic is well established for minor degrees of deformity which will
correct spontaneously to be referred for advice or treatment; the
majority of these cases of Knock Knee are developmental, occur
between the ages of 3 and 6 years and are non-rachitic.
I am glad to note that the number of cases of postural defects
of the spine has decreased, and this reflects the improvement in the
physical training given in the schools. Ideally, the general school
physical training should be supervised or carried out by teachers
with a physical training diploma and such should be available in
both the Primary and Secondary schools.