This study was designed to compare the rigidity of the more commonly used techniques of internal fIxation of fractures of the olecranon. Cadaveric elbow joints were mounted in a jig and confrolled osteotomies performed to simulate transverse, oblique or comminuted fractures. Five techniques of internal fixation were tested by measuring movement at the fracture site after

A study of cadaveric vertebral biopsy and a review of 100 clinical biopsies has shown that needles and trephines producing tissue specimens of two millimetres or more in diameter can be expected to give a high degree of diagnostic accuracy. The erythrocyte sedimentation rate was a more useful screening investigation than were estimations of serum alkaline phosphatase. The complications are described. It is suggested that patients with painful thoracic metastases and evidence of progressive cord compression should have early decompression after open biopsy if further neurological compromise is to be prevented.

The relative merits of different antibiotic regimens for prophylaxis in orthopaedic implant surgery are difficult to evaluate because of the low frequency of infection. Factors other than infection prevention may influence choice. We have compared 400 mg teicoplanin given intravenously on induction of anaesthesia with three perioperative injections of cefuroxime, in 146 patients undergoing total hip or total knee replacement. These interim results suggest that cefuroxime selects for increased extraintestinal carriage of faecal streptococci and teicoplanin for Proteus species. There were no significant differences between the regimen in the acquisition of coagulase-negative staphylococci or Clostridium difficile, post-operative diarrhoea, wound healing or wound infection. Both regimens were equally safe.

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The rigidity of five techniques of internal fixation of fractured phalanges is tested experimentally and compared. The clinical relevance is discussed.

A series of fifty one lesions arising in the hand is reviewed. Fifty nine per cent of the lesions arose from the joints of the hand which are also frequently the site of degenerative changes. Twenty five per cent of available radiographs also showed such changes. The aetiology and diagnosis of this condition, the treatment and the results are discussed.

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