1. Thirty-four cases of displaced fracture of the neck of the radius in children are reviewed with special reference to elbow and forearm function.

2. There were eight poor functional results-four after eighteen closed reductions and four after sixteen open reductions.

3. The causes of the poor functional results are recorded and the complications discussed. Union in a displaced position was the main cause of restricted movement. Deformity of the radial head due to avascular necrosis, and fibrous adhesions between the neck of the radius and the ulna, were other factors.

4. Fractures that were held reduced by Kirschner wires had better results than comparable fractures treated by closed reduction or op en reduction without fixation.

5. It is concluded that all fractures, whatever the age of the child, with angular displacement exceeding 15 degrees need accurate reduction. Closed reduction is not easy, and repeated check radiographs are needed to ensure maintenance of reduction. Certain of these fractures are unstable and require internal fixation with Kirschner wires.

1. Twenty-eight patients with pyogenic infection of the spine are reported.

2. Diagnosis was by clinical, radiological and bacteriological means. Investigations of the spinal lesions by needle aspiration or open operation was needed in four patients.

3. Treatment consisted primarily of antibiotics and rest.

4. Twenty-five patients were fit and well after follow-up of one to fifteen years. Three deaths occurred, but only one was directly connected with the infection ; urinary infection with paraplegia and haemophilia were the cause in two others.

5. The relatively benign course is stressed, as are some of the diagnostic pitfalls in the early stages, particularly with thoracic lesions.

1. A study of fifty-nine patients with protrusion of the acetabulum showed that they fell into three age groups: those in their teens, those aged thirty-five to fifty years, and those presenting from fifty-one years onwards.

2. The juvenile age group was investigated clinically and biochemically but no causative metabolic factor was found.

3. The familial incidence was confirmed by radiological and biochemical surveys of several families.

4. The results of treatment show that when conservative treatment is insufficient a total hip replacement gives the best result from operation.

1. Forty-five arthroplasties of the knee with the Walldius prosthesis are reported in forty-two patients, thirty-seven with rheumatoid arthritis and five with osteoarthritis.

2. There has been no structural failure of the prosthesis.

3. Sepsis required removal of the prosthesis in three cases, but arthrodesis was obtained in two of the three.

4. Serious loosening of the prosthesis occurred in one case only. Varus deformity occurred in one patient.

5. Radiological evidence of some movement of the prosthesis was present in six other cases but this did not seem to affect function.

6. It is concluded that this operation has a place in the treatment of the more seriously disabled patient, but should not be used when heavy demands are likely to be made on the joint.

The syndromes associated with a narrow lumbar spinal canal are described and discussed. In thirteen cases two main groups were evident, the larger group having mainly backache and root pain, the smaller group having intermittent claudication. A method of recognising the narrow spinal canal on plain radiographs is described, and a comparison made with normal controls. The findings at operation are reported and the importance is emphasised of making a wide laminectomy for decompression. Our thanks are due to the neurosurgeons of the South-West Neurosurgical Unit, Mr G. L. Alexander, Mr D. G. Phillips and Mr A. Hulme, who kindly allowed us full use of their clinical notes. We would also like to thank Mr G. Banham for the reproductions, Mr E. Turnbull for the drawing and the secretarial staff for their patient co-operation.

1. Delta phalanx is a rare congenital abnormality not to be confused with other forms of angular deformity of the phalanges.

2. The deformity needs radical treatment by repeated surgery because there is no tendency to spontaneous correction and growth of the phalanx is prevented by the epiphysial deformity.

1. Forty-eight paralytic dislocations of the hip have been studied and twenty-seven operations for correction of valgus deformity of the femoral neck have been done.

2. The differing features of dislocations occurring in poliomyelitis, cerebral palsy and meningomyelocoele are considered in relation to management after operation.

3. Early recognition of subluxation is essential to a successful varus osteotomy. An angle of 105 degrees rather than the 120 degrees previously recommended is advisable for children under the age of five.

4. Redislocation is most likely to occur in meningomyelocoele in which muscular imbalance is greatest, and in later cases where the acetabulum has become shallow by growth without the femoral head within it. It has not occurred as a late complication after weight bearing has been established, from a recurrence of valgus deformity.

1. A case is described in which the extensor indicis tendon was replaced by a short muscle arising from the soft tissues on the dorsum of the wrist.

2. The patient complained of pain in the hand after heavy use. This was considered to be due to constriction of the muscle by the extensor retinaculum. Division of the retinaculum was followed by a considerable improvement in his symptoms.

1. The results of viscosity measurements on a number of normal, traumatic and osteoarthritic synovial fluids from human knee joints are described and discussed.

2. A decrease of the viscosity of normal synovial fluid with age has been found.

3. The decrease of the viscosity with age and in the pathological groups is analysed and its relation to the viscous anomaly is considered (Fig. 6).

4. The question whether dilution or depolymerisation is the important factor in decrease of viscosity in these groups, and the value of viscosity measurements as a whole, are discussed.

5. Measurements of pH have been made on the same groups of synovial fluids and on the blood of patients in these groups.

6. The mean values for blood and synovial fluid differ significantly, and the pH of the synovial fluid of adolescents is significantly higher than at other ages.

7. There is no significant difference between the traumatic and osteoarthritic groups, but both are significantly less than the normal.

8. In both fluids the peak frequency in all three groups is the same, that for blood being 7·3 to 7·5 and that for synovial fluid being 7·5 to 7·7 (Fig. 7).