Objective-To determine whether the treatment of ankle injuries in an accident and emergency department could be improved by an audit of existing treatment and the creation and use of a protocol.

Benign normolipoproteinaemic acanthocytosis Acanthocyes, or spiky red cells, in neurological disorders have been described in association with normal serum lipoproteins,24 hypobetalipoproteinaemia,4 and abetalipoproteinaemia.' These cells are morphologically indistinguishable from "burr" cells, or "spur" cells in American reports (acanthos, thorn).' The third family in the United Kingdom with normolipoproteinaemic acanthocytosis is described here.

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