We report the results of a series of 59 unconstrained total arthroplasties of the elbow after a mean follow-up of 6.5 years (4 to 10). All the patients had rheumatoid arthritis. The indication for surgery was pain in all but one. Outcome was assessed by the Mayo Elbow Performance Index (MEPI).

Of the 59 arthroplasties, two were lost to follow-up. Ten patients died, but as two of their arthroplasties were failures we included them in the results. The outcome in the remaining 49 was excellent in 26 (53%), good in 15 (31%), fair in one (2%) and poor or a failure in seven (14%). There was an improvement in the pain score (p < 0.001), movement (p < 0.001) and function (p < 0.001). Two patients developed instability, but neither required further surgery. There was a mean increase of 21° in flexion and of 7° in extension.

The overall rate of complications was 33.9%. Lesions of the ulnar nerve, one of which did not recover, occurred in four patients, deep infection in two and stiffness in five. The rates of complications were similar to those in recent reports of other elbow arthroplasties.

We carried out a radiological analysis of 39 arthroplasties which showed radiolucent lines around the humeral component in 22 and the ulnar component in 15. There were lower scores on the MEPI for those with radiolucent lines around the humeral component.

1. Haemorrhage into the fascial compartment which contains the iliacus muscle and the femoral nerve is a common complication of haemophilia.

2. The iliacus haematoma syndrome is described and illustrated from the authors' study of thirty episodes occurring in twenty-four patients.

3. The anatomy of the iliopsoas fascia is described and the mechanism of femoral nerve compression explained.

4. Differential diagnosis, prognosis and treatment are discussed and the necropsy findings in one patient are presented.

5. An instance of iliacus haematoma occurring as a complication of anticoagulant therapy is recorded.

An isolated palsy of the anterior interosseous nerve of the forearm is described in a boy aged nine. It was cured by surgical division of a constricting fibrous band in the forearm.