In a series of 12 patients with inoperable gastric carcinoma who had treatment with a synthetic matrix metalloproteinase inhibitor (Marimastat) for more than one month, six developed a frozen shoulder or a condition resembling Dupuytren's disease. This suggests that the matrix metalloproteinases, a family of naturally occurring proteinases, may be involved in the pathogenesis of these two conditions. Our observation opens avenues for further research which could lead to local or systemic therapeutic interventions for frozen shoulder and Dupuytren's disease.

We report the long-term results in 32 patients with established nonunion of the clavicle; 15 treated with AO Dynamic Compression Plate and autologous cancellous bone graft and 17 treated with an AO reconstruction plate and autologous cancellous bone graft. The patients were followed up for a mean of 8 (4-21) years from injury and 7 (4-12) from non-union operation, both by clinical review and radiographs. 31/32 nonunions united successfully. One fracture which initially failed to unite was replated and subsequently united. 6 compression plates and 7 reconstruction plates were removed for discomfort or cosmesis. None broke. Both plates give equally good results, but we feel that the reconstruction plate is easier to contour to the complex form of the clavicle.

I n a series of 12 patients with inoperable gastric carcinoma who had treatment with a synthetic matrix metalloproteinase inhibitor (Marimastat) for more than one month, six developed a frozen shoulder or a condition resembling Dupuytren's disease.This suggests that the matrix metalloproteinases, a family of naturally occurring proteinases, may be involved in the pathogenesis of these two conditions. Our observation opens avenues for further research which could lead to local or systemic therapeutic interventions for frozen shoulder and Dupuytren's disease.

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We report our experience with severe digital deformities caused by prolonged finger sucking. Our analysis of nine patients demonstrated that the deformity was mainly located in the proximal and middle phalanges of the affected digit(s). We have reviewed the literature, enumerated the common patterns of "finger sucking" and explained the resulting deformities. Corrective osteotomy, preferably at the metacarpal base level, is required in severe deformities.