1. Twenty-seven patients with a Brown-Séquard syndrome resulting from trauma have been studied, fourteen of the left side of the cord and thirteen of the right. There were sixteen gunshot wounds and eleven closed injuries.

2. The prognosis for recovery is much better than the initial catastrophic nature of the symptoms and signs would indicate.

3. The pattern of recovery is discussed in detail and the long and rather tedious course of the treatment is indicated.

4. Spasticity on the side worse affected still presents a difficult problem, but a less severe one than that presented by flaccid paralysis.

1. The Moe plate has been used in 256 of 270 consecutive intertrochanteric fractures of the femur. There was an operative mortality of l8·8 per cent and an overall mortality of 20·7 per cent in a group averaging 75·2 years of age.

2. The method proved satisfactory, giving secure fixation and also approximation of the fragments by the lag action of the three large screws driven into the head. There was only one case of non-union.

3. In the survivors anatomical and functional results have been satisfactory in about 70 per cent, with half of these showing full functional recovery and the other half requiring only occasional use of a stick or crutch.

4. There are a few intertrochanteric fractures of the femur too comminuted for any form of internal fixation. Traction should be used in this group.

5. A varus deformity developed in about one half of the cases. This is consistent with a good functional result.

6. The main difficulty in these aged people has been survival. The problems have been discussed with suggestions that may perhaps reduce in part a mortality that seems inherent in this injury and at this age.

A classification of Smith's fractures into three types is proposed. It is suggested that the majority of these fractures are caused by a pronation injury. The reduction of Smith's fractures by supination is described and the importance of the supinated position during splintage is stressed.

1. Un reduced anterior dislocation of the hip is very uncommon. Four cases are reported.

2. The aim of treatment is to correct the deformity, to improve the gait and to produce pelvic stability.

3. Osteotomy of the femur at the trochanteric level is the simplest corrective operation and will greatly improve the function of the limb.

A method of intra-articular arthrodesis of the hip is described in which fixation is obtained with a lag-screw. Two main advantages are claimed: first, that it is a compression arthrodesis and gives early bony fusion; and second, that it gives adequate internal fixation in most cases so that the disadvantages of a plaster hip spica are avoided, and the patient may walk with crutches two or three weeks after the operation.

The results were satisfactory in forty-seven of the first fifty cases in which this method of arthrodesis was employed. There were two post-operative deaths and one failure to secure fusion in a case of massive necrosis of the femoral head.

1. Injuries of the sternum from flexion-compression violence are described and contrasted with injuries from direct violence. The characteristic feature of flexion-compression injuries is a dislocation or fracture at or near the manubrio-sternal joint with backward displacement of the manubrium.

2. Treatment is outlined, with special reference to the indications for open reduction and wire fixation.

3. The mechanism of flexion-compression injuries of the sternum is discussed. The opinion is expressed that most of the force is transmitted to the sternum by the ribs—especially the upper ribs.

1. In the course of 2,668 operations for suspected cartilage lesions 119 errors of diagnosis were revealed.

2. These errors are analysed and certain conclusions are drawn.

1. Three cases of anterior dislocation of the head of the radius associated with an undisplaced fracture of the olecranon are described.

2. A combination of pronation of the forearm and hyperextension of the elbow is suggested as a possible mechanism.

1. The detailed findings are presented of a woman aged fifty who had widely distributed ossifying skeletal tumours, the structure and form of which have been shown to be low-grade osteoblastic osteogenic sarcoma. The patient was treated with heavy doses of P³², to which is attributed some clinical improvement, but which induced a fatal aplastic anaemia.

2. The study of the several tumours, together with the history, the radiographs and the post-mortem findings, suggests that the lesions are multifocal skeletal primary tumours rather than numerous osseous metastases secondary to a solitary new growth in any one bone.

3. The focal neoplastic lesion is discussed in the light of personal experience of other osteogenic sarcomata of low grade but of solitary origin, and of the multifocal form of bone sarcoma which may complicate Paget's osteitis deformans.

A case of fatal air embolism after Küntscher nailing of a fractured femur is described. Necropsy indicated that the only possible means of air entry was through the bone marrow. Subsequent discussion between the surgeon and the pathologist indicated that air must have been forced into the venous circulation through the marrow by repeated removal and reinsertion of nails, which allowed air to fill the punched-out marrow space when the nail was removed, the same air being forced into the marrow sinusoids when the nail was reinserted and hammered into position. This danger may be overcome 1) by allowing the site of operation to flood with blood by placing the patient in a "head up" position; 2) by flooding the operation site with saline; or 3) by assessing the calibre of nail required by radiological means rather than by trial and error.

1. Reports of the lipaemia-clearing effect of heparin suggested that this drug might be of therapeutic value in fat embolism.

2. In an experimental trial with rats, heparin was found both to accelerate death and to increase the number of deaths after fat embolism.

3. It is accordingly concluded that a clinical trial of heparin in human fat embolism would not be warranted.

1. A case of local gigantism is described, with enlargement of the left thumb, the left ring finger, the right little finger, and the right second and third toes.

2. No other record can be found in the literature of an association of local gigantism of fingers of both hands with a similar condition of the toes of one foot, though there is no theoretical reason why macrodactyly should not affect the digits in any combination.

3. Theories regarding the etiology are discussed.

1. The lines of fracture confirm the suggestions of earlier authors on the lines of strength in cartilage, with the additional feature of a transverse plane of weakness at the apex of the calcified zone.

2. The normal nutrition of cartilage is synovial, and access of a free blood supply is followed by destruction of hyaline articular cartilage.

3. Minor traumatic events in the articular lamella are common, particularly in osteoarthritic joints; the results of these on the cartilage are like the changes of osteoarthritis.

4. The removal of uncalcified cartilage can be described in two stages of a physico-chemical kind; the removal of calcified cartilage is a single cellular process.

5. There is evidence that the carbohydrate moiety of cartilage is present in two separable phases, one fixed to collagen, the other free.

6. The repair mechanisms after fracture are those available to restore the damage of osteoarthritis, and reasons can be shown why in fact they are ineffective.

1. The principal nutrient canal of the femur in day-old rabbits was occluded and subsequent femoral growth observed.

2. An initial shortening is followed by equalisation and a final absolute shortening of the order of 3 per cent in occluded femora as compared with controls.

3. It is emphasised that the medullary arterial system, fed by principal nutrient, metaphysial and epiphysial arteries, is the mechanism for the delivery of arterial blood to long bones, and that the arteries of bone extremities are of overwhelming importance in the nutrition of the long bone as a whole.