The results of operation for traumatic anterior dislocation of the head of the radius in eight children have been reviewed. We are satisfied on the basis of the results obtained and the outcome in one untreated patient that operative reduction is fully justified, provided that the annular ligament is reconstructed and internal fixation employed. We have not seen unilateral congenital dislocation and doubt its existence. Secondary subluxation of the distal radio-ulnar joint has been noted in an untreated patient.

The pattern of fracture-dislocation of the upper part of the sacrum is demonstrated in three patients. The fracture line followed the segmental form of the sacrum and was usually caused by a posterior force against the pelvis which had been locked by hip flexion and knee extension. Fractures of the lumbar transverse processes also occurred, presumably from avulsion by the quadratus lumborum muscle. The damage to the sacral plexus found in all three cases recovered after several months. Radiographs of the injury are difficult to obtain in severely injured patients but oblique views of the sacrum help to determine the extent of the forward dislocation.

1. The case is described of a twenty-nine-year-old man with back pain due to an extensive vascular malformation replacing the major part of a vertebral body.

2. Treatment was by transthoracic ligation of the segmental vessels, with irradiation and spinal fusion later.

3. The importance of demonstrating the origin of the thoraco-lumbar supply to the anterior spinal artery is emphasised.