We present the results of a prospective trial of osteotomy of the metatarsal neck for hallux valgus in 31 feet of 23 women, using a new stapling device with no plaster splintage and early weight-bearing. Surgery was performed for pain (29 feet) and difficulty with footwear (nine feet). The average time for return to light work was 3.3 weeks, and to full work 8.3 weeks after operation. Seventeen patients had full recovery within three months and 21 of the 23 patients had complete relief of pain. Shoes were more comfortable in 17 feet and 9 patients could wear narrower shoes. Only two patients were unsatisfied with the appearance of the foot. All the osteotomies united, and the average hallux valgus angle was improved on radiographs from 35 degrees to 23 degrees. The mean first metatarsal angle was reduced from 16 degrees to 11 degrees. The new technique allows more accurate surgery and easier postoperative management.

We have reviewed 36 patients who had recurrent anterior dislocation of the shoulder after a previous anterior repair and analysed the various causes of failure. It was found that failure could have been avoided in virtually all of the patients by correct pre-operative diagnosis, selection of the appropriate operation and its proper execution. The further management of these patients is described and suggestions are made as to means of reducing the incidence of failure after primary operation.

The results of a prospective controlled trial of early mobilisation of Colles' fractures in the elderly are presented. Early mobilisation produced less pain and a stronger grip. It did not lead to any greater loss of reduction of the fracture. However, there was no significant improvement in the final range of movement of the wrist. Immobilisation of the wrist for six weeks in plaster is extremely inconvenient for the elderly living alone and the patients greatly appreciated the reduction of this period of time to a minimum.

A 21-year-old female athlete presented with bilateral lumps in her calves which became painful on exercise. Exploration revealed entrapment of the superficial peroneal nerves. Her symptoms were relieved by fasciectomy.