The thumb carpometacarpal joint is the second most common site of osteoarthritis in humans. There are numerous operations for the condition but, perhaps, the commonest is trapeziectomy, sometimes supplemented by a suspension procedure, most commonly using part of the flexor carpi radialis tendon. In order to determine whether there is an advantage to a suspension procedure, or not, 65 patients with Eaton and Glickel Grade III or IV arthritis of the carpometacarpal joint of their thumbs were randomised into either undergoing trapeziectomy alone (with no wiring) or a trapeziectomy with flexor carpi radialis suspension. Patient satisfaction from both operations was similar. There was increased range of movement in the trapeziectomy alone group, but there was no difference in grip or pinch strength. Measurement of the gap on X-ray left by the trapeziectomy was less when trapeziectomy alone was performed.

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Darrach's procedure was performed for post-traumatic symptoms in the inferior radio-ulnar joint in 36 patients, who were reviewed after a mean follow-up of 6 years. Only 18 of the patients had a satisfactory clinical result. Poor outcome was associated with osteoarthritis of the wrist, the occurrence of algodystrophy and a short ulnar remnant.

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Seven hundred and sixty-eight single-visit cases, of which 223 presented for a re-examination appointment ranging from 6 months to 4 years from the day of treatment, were considered. Four endodontists provided examinations for both root canal treatment and re-examinations. Clinical and radiographic data were used to form an overall impression of the outcomes for each case at the time of re-examination. Available demographics and treatment information of these 223 cases were compiled for comparison. The number of treatment visits was not determined by a pretreatment diagnosis or a re-assessment of the pulp status upon entry into the tooth; therefore both vital and necrotic cases, as well as those with and without periradicular pathosis, were included. Statistical analysis was carried out using Chi-square tests and considered variations in failure rates based on gender, provider, tooth type, position and arch. A t-test was used to evaluate data on age. The overall success rate was 89.2%. No statistically significant differences were seen based on gender, age, arch or provider. Statistically, anterior teeth were more successful than posterior teeth.

One hundred patients who had sustained a Colles' fracture were observed for features of algodystrophy at 1, 5, 9 and 12 weeks following injury. The diagnosis of algodystrophy was possible as soon as 1 week after fracture. Early diagnosis has important clinical implications: the aetiological factors may become apparent and different treatment modalities be identified; furthermore, early treatment can be started, limiting the morbidity of the condition. It is proposed that patients with features of algodystrophy require physiotherapy after a Colles' fracture. Those without features may not.

We describe a direct method of measuring the tightness of plaster casts. Tightness was measured weekly in 23 consecutive patients with Colles' fractures. Six had objective signs of algodystrophy nine weeks after the fracture. In these patients the plaster cast was significantly tighter during the first three weeks than in patients who did not develop algodystrophy. The complex relationship between these findings is discussed.