1. Arthrodesis of the hip is satisfactory provided a good range of knee flexion is preserved.

2. The hip is best arthrodesed in its deformed position, and the deformity corrected by a high femoral osteotomy. Knee range can readily be retained by treating the patient on traction for the first six weeks instead of using plaster.

3. Thirty-three arthrodeses were attempted without osteotomy. Only thirteen were satisfactory. Even our best method without osteotomy gave sound fusion in only seven out of ten cases.

4. In a series of twenty-three unselected cases in which osteotomy was performed in addition to other methods, fusion occurred in twenty-two.

1. This paper reports the investigation and the results of a line of treatment in thirty feet showing the peroneal spastic flat foot deformity. The questions that have aroused controversy are discussed, the evidence for previous opinions is examined, and some phenomena in relation to this condition are described.

2. It is suggested that previous opinions on this condition have been misleading, and have in many cases been made after incomplete investigation of too few cases.

3. Peroneal spastic flat foot can occur without a developmental tarsal anomaly.

4. The presence of a tarsal anomaly does not necessarily mean that the foot is incorrigibly stiff, and some of these feet show a full range of movement under anaesthesia.

5. There is no evidence from this series of cases to suggest that organic nervous disease or psychiatric disturbances played a significant part in the production of the deformity.

6. There is no evidence to suggest that the deformity is a manifestation of generalised rheumatoid arthritis.

7. This investigation does not reveal the cause of the deformity when the tarsal skeleton is normal, nor does it help to explain the reason for the onset of symptoms in a developmentally abnormal foot.

8. It is suggested that a tarsal anomaly makes the foot more likely, under average stress, to break down in this way, and that this deformity is also assumed by architecturally normal feet under heavy stress. In view of the frequency of minor tarsal anomalies among this series of thirty feet, it seems likely that all feet presenting the deformity of peroneal spastic flatness are to some degree structurally abnormal, although the exact site of the abnormality may escape us.

1. In the treatment of tarso-metatarsal fracture-dislocations open reduction is advocated whenever closed reduction is found impossible.

2. A technique of operation is described whereby, after reduction, temporary transfixion wires are used to prevent redisplacement.

1. The usual methods of posterior arthrodesis of the lumbo-sacral joint are not satisfactory in cases in which laminectomy has been performed.

2. Estimation of fusion by mobility radiographs is unreliable and cannot distinguish between fibrous ankylosis and bony fusion.

3. Bone grafts inserted from behind between the vertebral bodies almost invariably fail to become incorporated.

4. Intertransverse arthrodesis has given promising results and is probably the best method available at present.

1. Reduction of supracondylar fractures in children by lateral rotation of the arm combined with mechanical traction and manipulations is described. Fixation in a plaster shoulder spica is recommended.

2. The results are presented and seem to be satisfactory.

1. Thirty-eight cases of tuberculosis of the greater trochanter have been reviewed.

2. Classification into bursal and osseous infections is discussed, and reasons have been given for our belief that either lesion may be the primary one.

3. An attempt has been made to assess available methods of treatment. In general, conservative measures are recommended for primary lesions, and surgery for recurrences. We have the impression that chemotherapy is of definite value.

4. The incidence of spread of tuberculosis to the hip joint is discussed. In this connection, reasons have been given for condemning excision of the trochanter.

Descriptions of four previous cases of antero-lateral dislocation of the fifth carpometacarpal joint are reviewed and a further case is reported. Suggestions are made on treatment.

1. Previous papers on the subject of the os trigonum are reviewed.

2. Evidence is produced to show that the posterior part of the talus normally develops from separate centres.

3. An explanation is given for the presence in adults of separate ossicles (the so-called os trigonum) in one or both ankles and for the variety of shapes adopted by them.

4. Contrary to opinions expressed by previous writers, these ossicles may give rise to symptoms.

1. One hundred and seventy-nine cases of primary malignant bone tumour and giant-cell tumour seen at the Middlesex Hospital since 1925 are reviewed. Tumours arising from non-skeletal tissues in bone have been excluded.

2. The following histological classification is used. Osteosarcoma (osteoblast sarcoma): This tumour is not synonymous with osteogenic (bone-forming) sarcoma. The essential feature is the formation of osteoid tissue by malignant osteoblasts, with no intermediate matrix of cartilage or fibrous tissue. It is the most malignant bone tumour and only four of the thirty-two patients survived three years. Chondrosarcoma: These tumours are composed of cartilage, and some show secondary ossification. The behaviour of this group is related to the degree of cartilaginous differentiation. In general, compared with the osteosarcoma, it is of low-grade malignancy. More than half of the sixty-eight patients survived four years. Fibrosarcoma: The essential feature of this tumour is the production of collagen by malignant fibroblastic tumour cells. Tumours of this type invading the medullary cavity have an average prognosis between that of an osteosarcoma and a chondrosarcoma. Nine of the thirty-four patients survived three years. Spindle-cell sarcoma: These tumours are composed of spindle cells which produce no diagnostic matrix. In spite of the lack of differentiation the outlook is not hopeless. Six of the eleven patients survived for five years or more. Giant-cell tumour: This tumour is composed of a cellular stroma with diagnostic giant cells resembling osteoclasts. It is by no means a benign lesion, for half the tumours recurred after treatment and a quarter of the patients died with metastases.

3. The subdivision of primary malignant skeletal tumours into groups according to the histological pattern appears to be reflected in the behaviour of the individual tumours after treatment. The prognosis of each group has been stated in the appropriate sections.

1. A method is described of demonstrating in vivo the utilisation of radioactive sulphur³⁵ and of radioactive phosphorus³² during bone growth and repair.

2. The relationship between labelled chondroitin sulphuric acid and labelled phosphate complexes has been studied, the importance and significance of vascularity and the localisation of the enzyme alkaline phosphatase being noted.

3. It was found that bone growth by external accretion, both epiphysial and periosteal, was accompanied by an increased utilisation of radioactive chondroitin sulphuric acid and calcium phosphate complexes.

4. During repair in a fracture site, although there was deposition of radioactive phosphate, no preferential localisation of radioactive sulphur was observed and the possible explanations of this are discussed.

1. The detailed anatomy and calcification of the upper half of the tibia in rabbits varying in age from six weeks to twelve months has been studied.

2. The structure of the bone varies at different levels, but a section taken from the same level in the tibia from animals of the same age presents a reasonably constant picture.

3. It has been shown that this variation in structure at different levels is directly related to a difference between the axis of growth and the bone axis. This difference is a result of the unique shape of the tibia.

4. Autoradiographic studies confirm the localised concentration of radioactive strontium in areas of active bone formation where uptake is rapid.

5. The long retention of radioactive strontium in the skeleton (that is, the slow turnover) is a result of the slowness of resorption of bone (endosteal, periosteal or Haversian) in the cortex. Not only is the process slow but it is extremely localised.

6. The significance of these anatomical and physiological characteristics in relation to radiation injury is discussed.