We have reviewed 104 patients who had partial resection of the fibula for use as a graft. Only 44 were completely free from symptoms, and six had developed significant ankle instability which had required reconstruction by a sliding graft. This procedure successfully restored ankle stability in all six cases.

The hand-foot syndrome is a benign self-limiting condition seen in young children with sickle-cell haemoglobinopathy, usually at the time of a crisis. The authors have observed 36 cases among 4920 patients. The features and management of the condition are discussed and the published literature is reviewed.

Eleven cases are reported of contracture of the triceps muscle following intramuscular injections. This occurred in one arm of each of 11 children aged from 6 to 13 years, all of whom had a definite history of repeated injections. In seven of the cases the injections were of oxytetracycline. On presentation only 30 degrees to 35 degrees of flexion was possible. Physiotherapy for 4 to 12 weeks produced improvement, but in four cases early operation for excision of fibrous tissue and lengthening of the triceps was necessary to restore adequate flexion. Four other cases required operation after late relapse. The condition is rare, and is compared with similar and more commonly reported contractures in the quadriceps and the deltoid muscles.

The familiar picture of spinal tuberculosis is one of destruction of adjacent vertebral bodies and of the intervening disc. There are, however, other patients without these radiographic changes and with no clinical deformity who present with symptoms and signs of compression of the spinal cord or cauda equina. These patients fall into two different groups: those with tuberculosis of the neural arch; and those with extra-osseous extradural tuberculosis. Both may require laminectomy, but whereas the first has bony involvement and a cold abscess, the second has neither.