By this time he had established himself as more persistent image through the ensuing years one of the few world authorities on the knee, was of the “wee man’ dressed in an elegantly while continuing to be a brilliant and inventive tailored dark coat and a wide-brimmed, black surgeon, as well as an unusually charismatic and fedora. This was recognized by invita- Sadly, his final years were marred by severe tions to teach in many parts of the world, includ- physical disability, although his mind remained as ing North, Central and South America, Europe, alert as ever. Throughout this time he was cared the Mediterranean, and the Near and Far East. He all these places his monographs on Injuries of the died at his home near Blairgowrie in his 84th year. Knee Joint and Diseases of the Knee Joint had He was survived by Jenny, two daughters from his preceded him. The first went into five editions and first marriage and Jenny’s three children. These pub- lications were the result of personal observation, data collection, careful pathological analysis and considered judgment. The operations that he described were effective and saved many knees from considerable malfunction. Although some of these procedures have been superseded by new technology, the basic principles of comprehensive assessment, accurate diagnosis, and progressive rehabilitation still hold. Smillie’s academic and professional career was finally capped by his presidency of the International Society of the Knee from 1981 to 1983. He had many interests outside medicine: he raced exotic cars at Brooklands in the 1930s, and his serious interests included philately and pho- tography. His pervasive interests were farming, fishing and stalking—he published A Guide to the Stalking of Red Deer in Scotland in 1983. Ian Smillie was a complex character; some- times defensive, always enthusiastic, lacing his discussion and instruction with humor. He could Robert William SMITH be cutting in debate, but equally generous in praise when this was deserved. On one occasion, 1807–1873 an arch-rival attacked his techniques and the knives that he had designed, saying “The only use Robert William Smith spent his entire life in for which I can recommend Mr. He waited for it is in surgical pathology that he made his great- what seemed an age, then continued—“The best est contributions.
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Right: CT scan shows the fracture of L4 more clearly, with severe narrowing of the spinal canal. There is a horizontal fracture of the upper part of the vertebral body extending into the posterior elements. Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. Radiol Clin also be caused by sternal or bilateral rib fractures, as the North Am 1997;35:507–32 anterior splinting effect of these structures will be lost. A particular type of fracture, the Chance fracture, is London: BMJ Publishing Group, 1995 typically found in the upper lumbar vertebrae. It runs transversely through the vertebral body and usually results from a shearing force exerted by the lap component of a seat belt during severe deceleration injury. These fractures are often associated with intra-abdominal or retroperitoneal injuries. A haematoma in the posterior mediastinum is often seen around the thoracic fracture site, particularly in the anteroposterior view of the spine and sometimes on the chest radiograph requested in the primary survey. If there is any suspicion that these appearances might be due to traumatic aortic dissection, an arch aortogram will be required. Fractures in the thoracic and lumbar spine are often complex and inadequately shown on plain films. If the neurological lesion is complete the patient will have paralysed intercostal muscles and will have to In tetraplegia: rely on diaphragmatic respiration. Partial paralysis of the Intercostal paralysis diaphragm may also be present, either from the outset or after Partial phrenic nerve palsy—immediate 24–48 hours if ascending post-traumatic cord oedema —delayed Impaired ability to expectorate develops. In patients with injuries of the thoracic spine, Ventilation-perfusion mismatch respiratory impairment often results from associated rib fractures, haemopneumothorax, or pulmonary contusion; there In paraplegia: may also be a varying degree of intercostal paralysis depending Variable intercostal paralysis according to level of injury on the neurological level of the lesion.
Jared, 35 years: The NHIS-D asked only people with major mobility problems whether their difficulties would persist twelve or more months, and about 88 percent replied that they would. He was and of the Orange County (Florida) Orthopedic on the staff of the Philadelphia Orthopedic Hos- Society.
Leon, 51 years: Morphological improvement gained by manual reduction would lead to functional improvement of the hip and lower the risk of arthritis in the future. Your seniors will always question you in theatre on your anatomy and it pays to read up the night before.
Finley, 53 years: Validity refers to the truthfulness and appropriateness of information provided as evidence of learning and teaching. Neurophysiologic tests are the cornerstone of myoclonic classification and may indicate productive avenues of ther- apy.
Killian, 27 years: Early in his adminis- much favor upon specialization, and in certain tration an advisory editorial staff was organized. In the meantime, he told her to get extra rest and drink plenty of fluids.
Ressel, 21 years: The response of orthodox medicine to the challenge of alternative medicine in Australia. The preliminary results of the major research programme sponsored by the Department of Health (National Treatment Outcome Research Study) similarly claim success on a variety of outcome measures, though not that of enabling the user to become drug free (Glossop et al.
Raid, 64 years: The scarcity of research evidence about the effectiveness and clinical outcomes of therapy and assistive technology compromises efforts to make objective medical necessity decisions about the merit of mobility-related items and services. Br Med J 1987, 294:129–130 Journal of Bone and Joint Surgery, Harry Platt 3.