Introduction: Supracondylar fracture of the humerus is a common upper limb fracture in children. Treatment is controversial and often technically difficult; complications are common. Cubitus varus is the most common problem with a mean incidence of 30%. A variety of methods of treatment for displaced fractures have been recommended.

Materials & Method: We reviewed 20 cases of severely displaced grade III supracondylar fractures of the humerus in children. There was marked swelling and distorted local anatomy in all these cases. These fractures were managed conservatively with straight – arm lateral traction. The patients were treated in skin traction for 2 weeks. They commenced physiotherapy after that. The traction was applied with arm in 90 degrees of abduction and forearm in supination.

Results: None of the patients developed any complication. All had full range of movements. None had cubitus varus deformity and none of these patients required resurgery. There was a complete patient and parent satisfaction.

Discussion: Open or closed reduction with internal fixation is the most common method of treating these injuries. In some cases this can be very difficult and dangerous. The local anatomy and swelling may not permit this; hence non-operative measures have to be adopted.

Conclusion: We conclude that straight – arm lateral traction is a safe and effective method of treating these fractures especially when the local anatomy is disturbed and the swelling is making operative intervention more risky and difficult. Moreover this method is also appropriate in areas where access to specialised centres in treating these injuries is either difficult or delaying.

We compared the practice of four orthopaedic consultants as regards the use of MRI and arthroscopy to diagnose problems of the knee. In one year 324 arthroscopies and 66 MR scans were performed for this purpose.

We found that MRI is a reliable and cheaper alternative to ‘diagnostic arthroscopy’. We consider that patients with definite clinical signs merit an early ‘therapeutic arthroscopy’, but that all other knees should be investigated by MRI. This policy spares patients from unnecessary and expensive surgery.

Arthroscopy for diagnostic purposes should be used only with a specific purpose. Modern MRI can and should replace “having a look”.

We reviewed 28 patients with brachial plexus lesions caused by shoulder dislocation. Contrary to most other reports, we found that the neurological lesions involved the infraclavicular and the supraclavicular brachial plexus. With supraclavicular lesions the involvement was always of the suprascapular nerve, and this always recovered spontaneously. Isolated axillary nerve lesions had the poorest prognosis for spontaneous recovery. We explored all lesions that showed no recovery after three to five months and performed either grafting or neurolysis. We discuss the combinations of nerve lesions, their recovery, the surgical indications, and the operations. We also suggest a new classification for these injuries which is more clinically relevant than the anatomical classification of Leffert and Seddon (1965).