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.

Branchial cysts, sinuses and fistulae are reviewed with special reference to their origin, clinical features, pathology and treatment. The material consists of a survey of over 700 recorded cases, a series of 90 cases studied in retrospect with special reference to the pathology, and a personal experience of 42. It is suggested that a proportion of 'branchial cysts' do not arise from the branchial apparatus, but possibly may do so from epithelial inclusions in lymph nodes. It is accepted that branchial sinuses develop from the branchial apparatus, but there is little proof that such an entity as 'branchial fistula' exists.

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