1. Three hundred and twenty cases of tuberculosis of the hip joint have been analysed and the late results assessed three or more years after discharge from hospital.

2. The primary bone focus involved the acetabulum alone in 39·3 per cent; the acetabulum and femoral head in 34·1 per cent; the head of femur alone in 19·2 per cent, and the femoral neck alone in 7·4 per cent. In 101 cases widespread destruction of the joint had taken place by the time the patient first came under observation.

3. Premature epiphysial fusion round the knee joint of the affected side occurred in 23 per cent of all patients under the age of fifteen years.

4. When hip disease was complicated by multiple foci of active tuberculosis or by secondarily infected abscesses and sinuses, the prognosis was seriously worsened.

5. Significant late deformity occurred in 38·3 per cent of patients discharged with "sound" fibrous ankylosis, and in 60·5 per cent of those with an unstable fibrous ankylosis.

6. Of 187 patients observed for more than three years after discharge from hospital 174 returned to full activity, seven were partly incapacitated and six were totally incapacitated.

7. Analysis of the late results suggests that the prognosis is best when an adequate period of conservative treatment is followed by some form of arthrodesis operation.

1. Ninety-eight cases of fracture of the upper end of the tibia treated by operative reduction have been reviewed.

2. The true split fractures and the mildly comminuted compression fractures showed the best results. The "mosaic" cases showed the least satisfactory results.

3. Age has scarcely any effect on the end-results and is consequently no contra-indication to operation.

4. Nearly half the patients regained normal or almost normal mobility in the knee joint.

5. In no case did a meniscus left in place cause symptoms indicating internal derangement.

A patient with a chronic discharging sinus or an extensive adherent scar is never safe from the risk of malignant change. Examples are still occurring more than thirty years after the end of the first world war. The possibility should be kept in mind by those concerned with the long-term treatment of wounds of this kind. Reasonable prophylactic measures would be: excision of adherent or unstable scars with, if necessary, their replacement by suitable pedicle flaps having a good blood supply; and earlier amputation if a osteomyelitic sinus persists for several years and does not yield to treatment. Supervision of doubtful cases should be frequent and should not be relaxed with the passage of the years. Warty changes or indolent ulceration of scars should be regarded with grave suspicion and investigated by biopsy. Any increase in pain or discharge in association with a sinus should receive prompt attention. Finally, if malignant change supervenes, treatment should be as speedy and as radical as with any other cancer. At least thirteen of our twenty-four patients have died of cancer.

1. A series of 110 cases of trochanteric fractures treated by internal fixation with the Capener-Neufeld nail-plate is presented. The age incidence, mortality, complications and functional results are discussed in detail.

2. The results are compared with those of two series of cases treated conservatively: a) 101 cases treated conservatively in hospital; b) 25 cases sent home by reason of shortage of hospital beds.

3. From a consideration of these three series, and from study of similar series of cases reported in the literature, it is concluded that routine operative treatment of trochanteric fractures offers the advantages of lowered mortality, improved function, economy of hospital beds, and greater comfort and mobility of the patient.

4. Certain points in the management of cases during the operation and in the convalescent period are discussed.

1. The pathology of actinomycosis is briefly summarised, especially its method of invading bone by direct spread.

2. The manifestations, diagnosis and treatment of spinal involvement are considered.

3. The literature is brought up to date with a) a summary of fifteen cases published since the last collected series (forty-seven cases), and b) notes of three cases previously unreported, making, with the case reported on page 215 by Mr Brett, sixty-six cases in the literature.

A case of extensive spinal actinomycosis, undiagnosed for nearly five years, responded dramatically to large doses of penicillin, which was later supplemented by streptomycin.

1. Six cases of infection of wounds with actinomyces are described alld tile cultural characteristics of tile organisms are discussed.

2. In three patients the infecting organism was an unusual aerobic form.

3. Possible sources of infection are considered.

4. The chronicity of the condition and the difficulty in treatment are stressed.

5. Penicillin and X-radiation hold out most hope of cure.

A case is described in which a clinical diagnosis of "metaphysial dysostosis" was made, but in which histological examination of involved bones showed the changes of rickets, presumably renal, with secondary hyperparathyroidism.

1. It is suggested that replacement of the costo-clavicular ligament is mechanically an essential part of the operative treatment of recurrent sterno-clavicular dislocation.

2. Tenodesis of the subclavius appears to be the simplest and safest way of achieving such replacement.

3. Two cases are described of recurrent sterno-clavicular dislocation treated by this procedure and capsulorrhaphy.

4. Full function was restored in both cases; and there had been no recurrence at the times of follow-up—three years and six months after operation in the first case, and twelve months after operation in the second. In this case the joint had withstood violence that had shattered the clavicle.

5. Further trial in judiciously selected cases, with report, is suggested.

1. All articulating cartilages are fibrocartilages.

2. The articular cartilages of the synovial joints are largely composed of collagen fibres.

3. These fibres form a dense network, the fibres of which run obliquely between the articular surface and the bone.

4. This network is operative when the parts are at rest and in contact under pressure. It takes the tensile component of the resultant shear stress, and is a postural mechanism of the joint.

5. The articular cartilage is most heavily chondrified at its centre, between the juxta-synovial and juxta-osseous parts.

6. The technique for demonstrating the fibrous structure is described.

1) Supination and pronation are the only material tarsal movements; other terms describe their hypothetical components only.

2) The subtalar and talo-navicular joints form a single joint functionally, which may be called the peritalar joint.

3) Peritalar movement comprises a wide range of supination and pronation of the foot about an axis which passes from the tuberosity of the calcaneum upwards, forwards and slightly medially to the neck of the talus.

4) Midtarsal movement comprises a narrow range of supination and pronation of the foot about an axis similar to that of peritalar movement.

5) Tile peritalar and midtarsal joints are thus oblique hinge joints.