1 . A ten-year study of fifty-four operations for transplantation of the hamstring muscles in thirty-one spastic patients has been made.

2. Twenty-one patients were improved after operation, six were not improved, and in four the duration of follow-up was too short for proper assessment. One patient died from other causes.

3. Greatest benefit was not obtained until one year after operation.

4. The results varied considerably in different grades of spastic patient. Important factors affecting the results were age, sex, personality, balance and function of arm and hip. Hand and major hip operations should be carried out before hamstring transplantation.

5. The objectives of operation are discussed. These were most consistently achieved in older, more ambitious or more responsible males with good balance and with good arm and hip function.

6. Factors which were of less direct importance were mental capacity, minor degrees of limb length inequality, and foot deformities.

7. Operative correction of foot deformities should not be done before hamstring transplantation.

8. Serial plaster correction of the knee flexion deformity before operation is preferred to division of the patellar retinacula.

9. Transplantation of the hamstrings to the patella in spastics is under trial.

1. Two cases of an unusual forefoot injury are recorded in which dislocation of the base of a metatarsal bone is associated with, and tends to perpetuate, dislocation of the metatarsophalangeal joint of the adjacent toe.

2. The anatomical and mechanical relationships between these linked dislocations are discussed, as are the principles of treatment.

3. The concept of segmental injuries to the forefoot is introduced.

1. A case of discoid medial cartilage is describe—the fifth so far recorded—and comparison is made with the previous cases in the literature.

2. The origin of the anomaly, its incidence and clinical features are discussed.

3. The view is expressed that discoid cartilage is a congenital lesion due to abnormal development, fibrocartilage being laid down in mesenchyme which normally disappears in the formation of the joint. It is not the effect of arrest of a normal process or persistence of a normal foetal state. The only time at which a cartilage may be said to be disc-shaped is in the earliest weeks of embryonic life, when the disc or plaque of undifferentiated mesenchyme is present between the developing bones. The central part of this mass disappears early, and the fibrocartilage develops in its peripheral portion. In a ten-weeks'-old embryo (37 millimetres) the cartilages were shown to have a crescentic shape like that of the adult cartilage.