1. The results of treatment of 134 patients with congenital dislocation of 167 hips are reviewed.

2. Late diagnosis is still a major problem.

3. Subluxations rarely give rise to poor results, but in dislocations first treated over the age of five years there is a one-in-three risk of failure.

4. Manipulative reduction is successful less often than reduction on a frame and carries a higher risk of avascular necrosis.

5. Closed reduction on a frame was satisfactory in 58 per cent of patients under the age of three years, and can succeed up to the age of five.

6. Open reduction was required in 20 per cent of cases under the age of three, and can be used successfully up to the age of six.

7. Seven anatomical barriers to closed reduction have been recognised and two or more are commonly found in one hip when open reduction is performed.

8. The acetabular roof may fail to develop after reduction, especially if this is delayed. A C.E. angle of under 20 degrees does not necessarily forebode this, unless measured on an arthrograph. Sclerosis of a sloping acetabular roof is an indication for operation. Acetabuloplasty is the proper operation for a sloping acetabulum and can be done successfully up to the age of twelve. Over this age, a shelf operation should be performed; this is appropriate also in younger patients in whom the curvature of the acetabulum is normal but does not extend far enough laterally. These operations were required in 38 per cent of hips treated in patients under the age of three, and in 64 per cent over this age. There is a one-in-three risk of avascular necrosis when acetabular reconstruction is done in patients under three.

9. Anteversion, if excessive, should be corrected by subtrochanteric osteotomy, and any valgus of the femoral neck should be corrected simultaneously.

10. Unilateral dislocations in patients over the age of six are best treated by Colonna's operation. In our few bilateral cases over this age our results have been disappointing.

11. Avascular necrosis is less common but more serious when it occurs over the age of three. Manipulative reduction and the use of frog-leg plasters are two avoidable factors which appear to increase its incidence. The more serious degrees are accompanied by stiffness of the hip, and when this sign is present weight bearing should be avoided.

12. Prolonged, though rarely permanent, limitation of movement occurs in some 10 per cent of cases. In a few, operative correction was required.

1. A medial approach is preferred for arthrodesis of the wrist in reconstructive surgery because there is no interference with the extensor tendons.

2. The value of pre-operative assessment by a trial period in plaster is mentioned.

3. The technique of operation is described.

4. In the absence of active pronation, screwing the ulna to the radius in 45 degrees of pronation is advised.

5. The necessity for securing haemostasis before closing the wound is emphasised.

6. Thirty-four cases are reviewed. The shortest follow-up was one year and the longest twelve years. The result was satisfactory in all cases. Most patients were discharged from hospital after the plaster had been changed two weeks after operation. Union occurred in about sixteen weeks.

One hundred cases of Lambrinudi's arthrodesis are reviewed. The shortest follow-up was one year. and the longest twenty-seven years. Thirty-seven per cent were successful. Nineteen per cent were failures; many of these were associated with faulty technique, and one method of operation which gives good results is described.

Success is likely if there is a balance of power between the dorsiflexors and plantarflexors of the ankle, especially if there is some fixed equinus before operation.

Success is less likely when the operation is done for a flail foot. In such circumstances arthrodesis of the ankle may have to be considered subsequently for instability of the lateral ligament, recurrence of dropfoot, or arthritis which may develop in the more active patients.

Age in itself is no bar to success, but pseudarthrosis is more likely to occur in patients over the age of twenty.

1. The so-called adamantinoma of long bones is a clinico-pathological entity, the pathogenesis of which is still in doubt. The case for its being a synovial sarcoma showing epithelial differentiation is in our view unconvincing.

2. The tumour is slowly growing, and of low grade malignancy. Apparent cure has been effected in a third of the total cases recorded by amputation or resection of the diseased bone.

3. These means, however, have not prevented metastases to the lungs and skeleton in a similar number.

4. A case is presented in which a metastasis appeared in the chest twenty-two years after amputation of the leg. This was sensitive to telecobalt irradiation, and is the first case in which a distant metastasis has been proved microscopically.