1. A Nigerian patient with radiographic features of osteopathia striata, osteopoikilosis and melorheostosis is reported. Also radiographs of a patient from the Radiographic Museum of the Institute of Orthopaedics at the Royal National Orthopaedic Hospital are reproduced because they show a similar mixture of these conditions.

2. lt is probable that a common factor is present at some stage in the development of melorheostosis, osteopathia striata, osteopoikilosis and possibly osteopetrosis.

1. The factors producing electrolytic corrosion of stainless steels are reviewed, and it is shown how several factors operating together can accentuate corrosion in certain positions in the plated fracture.

2. These factors can be minimised by good metallurgy and good engineering on the part of the manufacturers.

3. When and if materials become metallurgically satisfactory, or a truly inert substitute for metal is discovered, it will be possible to assess the true contribution of infection, faulty operative technique and mechanical factors to the failures of internal fixation. Such a critical assessment of these probably more important factors is at present bedevilled by uncertainty as to the purely physical condition of the materials as supplied to the surgeon.

1. A case is described in which a malignant tumour developed in the soft tissues at the site of a bone-plating operation performed thirty years before.

2. The plate and screws were found to be composed of dissimilar metals and a difference of potential existed between them.

3. A careful consideration of the history and clinical course indicates that the tumour arose because of the presence of the metals.

1. A case of multiple pseudo-cystic tuberculosis in an American Indian infant is described.

2. The extensive lesions in the skull of this infant are considered to be of particular interest.

3. The possible significance of a bony lesion present at birth is discussed.

The medical treatment of eight patients with paraparesis associated with Paget's disease of the vertebrae is described. Treatment, for 3 to 87 months, with calcitonin or with diphosphonates produced marked clinical improvement in seven of these patients. From this series and a review of 19 additional case reports it is concluded that favourable clinical response is seen in about 90 per cent of patients, and that this may occur very rapidly. Results are as good or better than those obtained by surgical decompression. It seems possible that paraparesis in some cases may be due to diversion of blood supply from the spinal cord to the highly vascular Pagetic bone giving rise to a vascular "steal" syndrome. It is suggested that medical treatment should be used more widely to avoid or delay the need for operation and reduce the risks of recurrence. These patients, however treated, require lifelong follow-up because relapses are common

We evaluated 38 hip reconstructions in 36 patients at a mean follow-up of 5.9 years (range 4 to 9.1) after femoral head allografts had been used to augment severely deficient acetabular bone stock. The patients were all relatively young and had many previous operations. Their pre-operative Harris hip rating averaged 46 points (range 18 to 73). All the allografts united and there were no infections. However, 12 acetabular components (32%) became loose; six of these had needed revision using the healed allograft, and two hips had required resection arthroplasty. The 30 surviving hips had a mean Harris hip score of 82 points. Some radiographic evidence of graft resorption was seen in 23 hips, though this was mild in 17. The extent of cover provided by the allograft and the severity of graft resorption both correlated with acetabular loosening. Although structural allografts had allowed successful hip reconstructions in many of these patients with major bone loss, the failure rate had increased from zero at four years to 32% at six years; clearly they provide only a short-term solution

1. Shin splints in five horses is described as a stress fracture of the second metacarpal bone. 2. The value of this finding in relation to stress fracture of the tibia in man is discussed