1. Idiopathic calcification of articular cartilages is described in a Jamaican woman of thirty-one years who had intermittent joint pains for ten years and who had evidence of past gonococcal infection. She was otherwise normal. 2. The etiology of the condition is unknown. 3. Previous literature is reviewed

1 . Three cases of triphalangeal thumb are described in three generations of a Bantu family. In the youngest member both thumbs were affected; in his mother and grandfather only one thumb was abnormal. 2. The literature is reviewed and the etiology of the anomaly is discussed. 3. Attention is drawn to the hereditary tendency of this condition

A benign chondroblastoma of bone is reported. It was unusual because it occurred in an old lady, in a toe, and it was not painful and radiologically resembled a chondroma. The coarsely lobulated tumour showed a varied microscopic appearance, but it consisted chiefly of closely packed sheets of small, round polygonal or fusiform cells. There was some calcification present. The literature is reviewed

1. The case of a girl aged sixteen years who avulsed the iliacus muscle from the ilium during a gymnastic exercise is reported. 2. The lesion was complicated by paralysis of the femoral nerve from pressure by the haematoma. Recovery occurred after decompression. 3. Reports of similar cases from the literature are reviewed

A case of paraplegia presumed on clinical grounds to be due to bilharziasis is reported. The patient was treated with antibilharzial drugs and steroids. She has been followed up for eight years and has recovered almost completely. The literature is reviewed, and the incidence and types of spinal lesion, the possible routes of infection and the diagnosis and treatment are discussed

Seven patients with macrodactyly in the foot are reported. None showed any stigmata of neurofibromatosis and all were found to have excessive accumulation of fibro-fatty tissue as the most striking pathological feature. It is suggested that this may represent the basic lesion in this condition. The literature is reviewed and attention is drawn to the differences between macrodactyly in the hand and in the foot

1. A case of giant-cell tumour of the proximal end of the humerus treated by resection and fibular grafting twenty-nine years ago is reported. An excellent functional result has been maintained. 2. The literature is reviewed and the results claimed by earlier workers are noted. 3. The present field of application of the operation is probably in cases of advanced or recurrent giant-cell tumour of bone

The case histories and investigations for five adolescent girls with a presumed diagnosis of either primary acetabular protrusio or acute idiopathic chondrolysis are presented. The follow-up ranged from three to nine years. All were treated by extensive soft-tissue release but in no case did this improve movement of the affected hip and permanent stiffness was the inevitable result. The literature is reviewed and methods of treatment are discussed in the light of the CT findings

1. Two cases of fracture-dislocation of the trochlea are described. One case was complicated by complete ulnar nerve palsy. 2. The injury is caused by direct force applied to the point of the elbow, or it may be associated with posterior dislocation of the joint. 3. Open reduction is recommended, the fragment being held in position by soft-tissue sutures alone. 4. Four other cases mentioned in the literature are reviewed

1. Two cases are reported in which there was diffuse fibro-fatty overgrowth or tumour formation involving the adipose tissue of the median nerve. In each the diagnosis was confirmed by operation and histological examination. 2. The first case is an example of the developmental abnormality usually referred to as "macrodystrophia lipomatosa." The second case should be termed fibrolipoma. 3. The literature is reviewed; no case of fibrolipoma has been recorded

A case of hyperplastic callus formation is reported in a girl of eleven; several bones were affected. There were no associated fractures. She is believed to be suffering from a mild non-familial type of osteogenesis imperfecta without blue sclerotics and presents multiple bony excrescences unassociated with injury. The relevant literature is reviewed. The effect of a trial of treatment with A.C.T.H. and with deep x-ray is reported

Reports of excision of the clavicle in the nineteenth century literature are reviewed, and certain operative complications discussed. Osteomyelitis was the most common indication, and was described first in this country by Syme in 1833. The first successful excision of the entire clavicle was performed by McCreary of Kentucky in 1813. The removal of tumour-bearing clavicles provided memorable challenges at a time when anaesthetics were not available, blood transfusion unknown and antibiotic therapy non-existent

1. Three cases of cystic angiomatosis of bone are presented and the literature is reviewed. 2. The typical radiological appearances are described and illustrated. 3. The diagnosis must be confirmed by biopsy, and it is essential that the bone removed should be from an involved rib. 4. The prognosis is dependent upon extraskeletal visceral involvement and is not influenced by radiotherapy or chemotherapy. Splenectomy may improve the chance of survival when the spleen is the only viscus involved

1. A child with so-called ischio-pubic osteochondritis is reported from whom the affected ramus was resected. The features observed in the resected specimen were those of a normal closing epiphysis. 2. The literature is reviewed with emphasis on other children who had biopsies and on large scale radiographic surveys of normal children. 3. The conclusions are that the changes in the ischio-pubic synchondrosis cannot justifiably be called osteochondritis, and that they require further investigation, which can most profitably be done at necropsy

1. An anatomical study of congenital club foot in various stages of foetal development is presented, and the literature is reviewed. 2. The most striking finding was deformity of the talus and in particular a change in its angle of declination. 3. That deformity was present in feet whose deformity could not be corrected by gentle manipulation; it was absent in feet whose deformity could be so corrected. 4. Abnormality of the tendon and insertion of the tibialis posterior muscle was found in most cases. 5. Speculations are advanced concerning the nature and cause of the talar deformity

1. Locking of the metacarpo-phalangeal joint from articular derangements is rare. 2. A case due to an intra-articular loose body is described. 3. The literature is reviewed. The commonest cause is catching of the volar capsule or collateral ligaments on osteophytes about the metacarpal head, but intra-articular bands, incongruities of the articular surface and entrapment of the sesamoid have also been described. 4. An analysis of the reported cases suggests the likely cause in the individual patient. 5. Operation is usually required to restore joint motion

1. Two cases of costal chondritis are presented. The special features and treatment of this condition are described and the literature is reviewed. 2. Early diagnosis and energetic treatment of costal chondritis obviates serious morbidity. 3. Treatment with antibiotics is of value in curing the condition before cartilage necrosis has occurred and in controlling the spread of infection to neighbouring tissues. 4. Excision of all necrotic cartilage is essential for cure, if cartilage necrosis has occurred. 5. Secondary infection with organisms of low virulence, notably pseudomonas pyocyanea, is nowadays the commonest cause of chronicity

This paper reports a prospective study of 72 consecutive patients with fractures or fracture-dislocations of the upper end of the humerus, treated during 1981. Most were elderly and treatment was conservative. Of the 72 patients 64 were followed up for a period of six months. Observations were made on the type of fracture, the speed and pattern of recovery of shoulder movements, on the time of commencement of physiotherapy, and on its duration. We found that with conservative treatment alone, 94% of our patients had good or satisfactory results at six months from injury. The criteria for manipulation are discussed and the literature is reviewed

1. Four cases of vascular injury during lumbar disc removal are reported, and the literature is reviewed. One of the cases is unique in that the inferior mesenteric artery was transected. 2. Clinical syndromes associated with various vascular injuries are discussed. 3. The possibility ofvascular injury should always be kept in mind during lumbar lam inectomy for disc prolapse. Unexplained hypotension is strongly suggestive of a vascular catastrophe. The advent of high output cardiac failure in the patient who has recently undergone lumbar disc removal is almost diagnostic of traumatic arteriovenous fistula

1. A clinical study has been made of heterotopic ossification in 273 patients with paraplegia of traumatic and non-traumatic origin treated at the Liverpool Paraplegic Centre over a period of twelve and a half years. 2. The literature is reviewed and theories of etiology are discussed. 3. Etiological factors have been studied. Prominent among these is inadequacy of early treatment leading to urinary infection and to the formation of pressure sores. 4. It is concluded that there is no effective treatment for established heterotopic ossification. 5. The importance of prophylactic treatment is stressed. Special emphasis is placed on adequate primary treatment, correction of hypoproteinaemia and early mobilisation