1. A case of ulnar nerve compression at the wrist caused by rheumatoid arthritis producing motor and sensory changes is presented.

2. The diagnosis from compression at the elbow can be determined by electromyography.

3. It may be that lesions of the deep branch leading to motor changes only occur in rheumatoid arthritis more often than is suspected, their effects being hidden by the concomitant disease and its associated muscle wasting.

1. A diagnosis of upward translocation of the dens was made in eight patients with chronic rheumatoid arthritis selected from a group of patients who had radiographic studies of the cervical spine and from whom a number of patients with atlanto-axial subluxation were also identified.

2. Two of the patients presented with an acute neurological syndrome of serious import and required a stabilisation operation. Though this is an uncommon complication of rheumatoid arthritis it seems that urgent neurological syndromes are likely to be more common than in atlanto-axial subluxation.

1. This paper presents the neurological findings in forty-one patients with rheumatoid arthritis complicated by atlanto-axial subluxation.

2. A method of radiological measurement of the subluxation is described. The extent of neurological involvement was found not to correspond with the degree of subluxation.

3. Fusion of the atlanto-axial complex or of the occipito-atlanto-axial complex is indicated only in patients with progressive neurological signs and in those suffering from acute neurological episodes.

4. Difficulty in obtaining fusion with cancellous bone grafts alone was encountered and we recommend wiring of the laminae C.1 to C.2 in addition.

1. The results of excision of the distal end of the ulna in eighty-six wrists of seventy patients suffering from rheumatoid arthritis are presented.

2. There was relief of pain in 93 per cent and restoration of full rotation in 87 per cent.

3. Further destructive changes of the radio-carpal joint were seen in 85 per cent, but these did not affect the good clinical results.

1. The results have been reviewed of forty-two traumatic dislocations of the knee in forty-one patients, twenty-six of which were treated conservatively.

2. Primary operative repair was carried out in only three cases, although a further ten had operative intervention for various complications.

3. It was not possible to compare the results of operation with those of conservative treatment, because the operative procedures were so diverse in nature.

4. The conservative treatment of twenty-six dislocations yielded surprisingly good results with regard to stability, absence of pain, and range of flexion movement.

5. In general, immobilisation for long periods, like operative repair, led to reduced movement.

6. In the absence of complications, conservative treatment is the method of choice.

1. In twenty-five patients with rheumatoid arthritis of the knee examined by contrast arthrography certain typical features were encountered. These consisted of enlargement of the suprapatellar pouch and loss of the normally smooth outline of the joint cavity because of nodular filling defects. In some cases less definite filling defects were seen, due to loose fibrinous deposits, particularly in popliteal cysts.

2. This method of assessment of the results of synovectomy of the knee correlated well with the clinical findings. The more satisfactory the clinical result the more normal the arthrograph. Patients who had recurrence of pain, swelling and tenderness in the knee showed arthrographic findings similar to those before operation.

1. A technique of closed instillation-suction for the treatment of chronic bone infection is described in which infected bone is first exposed and all necrotic material removed. Three perforated drainage tubes are inserted, and brought out through the skin some distance from the wound. The perforated parts of the tubes are laid close to the infected area and the wound closed in layers. Two of the tubes are connected to a drip bottle containing antibiotic solution, and the third to a continuous suction pump. Closed continuous instillation-suction is thus established, and has been maintained for up to six weeks.

2. The results in twelve cases are presented, two-thirds of which showed clinical resolution of the infection.

A case of cervical traumatic paraplegia is described in which there was no evidence of damage to vertebrae, discs or ligaments. Experimental evidence suggests that such injuries may be caused by inward bulging of the ligamentum flavum during hyperextension. The reasons why this inward bulging may occur, despite the elasticity of the ligamentum flavum, are discussed. Treatment of such cases is considered and the importance of avoiding extension emphasised.

1) A case is reported of paraplegia with normal radiographic appearances in which cervical cord damage was shown at autopsy to have been due to hyperextension injury.

2) The mechanism of such injuries is discussed, together with the differential diagnosis from acute prolapse of an intervertebral disc.

3) The grave dangers of using the fully extended position of the cervical spine in the management of these cases is noted.