Treatment of unicameral bone cysts ranges from injections of corticosteroids, bone marrow with allogenic demineralised bone matrix to open bone grafting procedure. These procedures have their own disadvantages in form of infection, fracture, long-term morbidity, repeat procedure and high recurrence rate.

We describe here a new, technically simple and safe technique with minimal morbidity and short hospital stay. We treated 2 young children with active bone cyst (that did not heal with pathological fractures in past 18 months) by this technique and in both the cases bone cyst healed without any complications.

In patient with active bone cyst at the proximal end of humerus, under image intensifier control distal humerus perforated with 3.5 mm drill and a pre bent 2.5 mm, flexible, intramedullary nail passed into the medullary canal and then to proximal end of bone cyst. Nail now rotated sequentially at 5 mm intervals to destroy the architecture of the cyst completely until no resistance is felt. Wound closed with skin sutures and steristrips. Post operatively both children were comfortable and discharged home next day. In both cases cyst healed uneventfully.

Though we have small experience but technique looks very promising.

Study Design: Case report of four consecutive case reports of revision surgery for anterior dislocation of the Acroflex disc (DePuy Acromed, MA, USA) all of whom required vascular surgery are described.

Objective: To describe vascular complications of explanting an artificial inter-vertebral disc replacement following spontaneous anterior displacement.

Subjects: Four consecutive patients required explantation of the Acroflex disc. Two patients were male and two female with median age 44 years (range 33–51). All patients gave informed consent to enter a clinical trial, which had ethical approval.

Outcome measures: Symptom relief, vascular injury and deep vein thrombosis.

Results: All patients gained good symptomatic relief following disc replacement. Four patients suffered anterior displacement of the disc with a deterioration in symptoms during the 1^st year. Three suffered vascular damage to the iliac vessels. In two cases division and re-anastomosis of the iliac vein was required to allow disc removal. Ilio-femoral deep vein thrombosis occurred pre-operatively in one patient and post-operatively in a second, no deaths occurred.

Conclusions: Anterior intervertebral disc displacement is associated with vascular injury. Preventing anterior disc displacement must form an essential part of disc design with (i) rapid fixation to bone and (ii) a failsafe design to prevent local damage in case of failure. In the case of displacement, disc removal should be planned and performed with a vascular surgeon.

The use of a forearm cast for paediatric buckle fractures of the distal radius is widespread practice. These fractures do not displace and follow-up in Fracture Clinic is only for cast removal. This may mean missed school for the child, or work for parents.

Modern materials allow a robust lightweight back-slab to be used for protection of these stable, though painful, injuries. Unlike a plaster of Paris backslab, Prelude? (Smith and Nephew) is removed by unwrapping the outer bandage. Parents can do this at home.

We prospectively studied 41 consecutive children aged 12 or less with buckle fractures of the distal radius, presenting to Fracture Clinic. After the diagnosis of isolated buckle fracture was confirmed, a Prelude? cast was applied. Parents were given a full explanation and written instructions, which were also sent to the GP. Telephone follow-up was carried out at 3–4 weeks.

Forty of forty-one parents expressed satisfaction with both the treatment and the instructions. The parents of one patient misunderstood the instructions, re-presented to fracture clinic and were dissatisfied for this reason.

With modern casting materials and adequate instructions at Fracture Clinic, routine follow-up of patients with buckle fractures is unnecessary. Resource savings can be made in this way with no compromise to patient care and increased patient/ parent satisfaction.