Obstetrics and Gynæcology

absence or depression of pain sensation and the continuation of physical activity. be author observed 118 cases, and arrives at the conclusion that the behaviour of the bones and the joints can be explained on the basis of the usual response to trauma modified by absence of prot.ective sensation. He emphasizes that fractures are important in the initiation of the condition, which is not. obvious in the review of the lit.erature. These fractures may be minimal, or they may be stress fractures. Continued activity leads to reaction in the joint and gradually increasing destruction. This finding emphasizes that this change can be prevent.ed by the early recognition of fractures and proper fixation and protection of the injured area. If the characteristic changes have developed, debridemenf, osteotomy and fusion can be carried out with success provided that the same principle of mobilization, rest and restriction of damaging activity can be maintained.