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The socio-economic effect of 156 hand injuries was studied prospectively. The average cost per injury was IR 474.28 pounds of the more serious injuries utilized two-thirds of the resources and resulted in 83% of the days lost from work. In the working population approximately 50% of hand injuries occurred at work. In assessing the economic impact of hand injuries, labour costs account for 55 to 65% of costs. Amputation and complicated laceration were the most costly and resulted in more days lost at work. Injuries at work result in greater costs because they involve more serious injuries, and because workers requiring manual skills need a higher level of hand rehabilitation to return to work. Unless the labour costs are taken into account, the true impact of hand injuries is greatly underestimated.

A study of excision arthroplasty (Girdlestone's pseudarthrosis) for infected total hip replacements is presented. Twenty-two patients were reviewed with a minimum follow-up of one year. Reduction in pain was significant but the functional results were poor. Factors contributing to poor function were old age, poor medical condition and arthritis of the contralateral hip; these were in addition to the gross instability resulting from the pseudarthrosis. The patients were easily fatigued and dependent on external supports; calipers were found to be unacceptable. The symptoms after excision arthroplasty are compared with those before the original hip replacement.

A case is reported of spontaneous rupture of the biceps femoris muscle, a hitherto undescribed condition. A characteristic history is discussed and a new clinical sign described.

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