Congenital vertical talus was diagnosed in 15 feet of 10 children, and was treated by operative reduction. Forefoot deformity was corrected first, using anterolateral soft-tissue release on 1 1 feet, and manipulation alone in four feet. After prolonged immobilisation in plaster the affected feet had posterior release at the ankle and elongation of the calcaneal tendon. Clinical and radiographic examination at follow-up 15 months to 21 years later showed that a satisfactory outcome had been achieved in 12 of the 15 feet.

One hundred and twenty-five patients with 194 feet affected by congenital talipes equinovarus were treated by the senior author during the period 1959 to 1980. Of these, 70 patients presented either at birth or in the early neonatal period, and 55 were seen later, having been referred from other centres. Seventy-five patients were subsequently reviewed by two of us; the remaining 50 were assessed from records and research files. Patients seen within four weeks of birth were termed "early", the remainder "late". Of the early group of 70 patients, 44 (with 68 affected feet) were reviewed and 26 (with 41 affected feet) were assessed from records. Excellent or good results were achieved in 94 per cent of feet treated conservatively and in 82 per cent of feet which required pantalar release. Of the 55 late referrals 32 patients (with 55 affected feet) were reviewed and 23 (with 30 affected feet) were assessed from records. Satisfactory results were slightly less frequent, but were achieved in 75 per cent of cases. There was no statistical correlation between early soft-tissue release and a good final outcome, but there was a positive statistical correlation between good clinical results and a high talocalcaneal index. Osseous correction (a laterally based wedge tarsectomy or a triple arthrodesis) was necessary at a later date in four feet (four per cent) of those who presented early and in 13 feet (15 per cent) of late referrals.

1. Eleven cases of congenital flat foot were studied, five of which are illustrated. 2. Ten of these cases were treated in infancy and followed for at least three years. In two cases the follow-up period was ten years and fifteen years. 3. An essential component of the deformity is equinus of the calcaneus, and treatment consisted of correction of the forefoot deformity by repeated manipulation, followed later by elongation of the calcaneal tendon and capsulotomy of the ankle. 4. The importance of recognising the deformity and beginning treatment in infancy is stressed.

Forty-three patients with 69 feet affected by isolated metatarsus adductus et supinatus were reviewed. of these, 20 patients (with 31 involved feet) had been treated expectantly and spontaneous resolution had occurred with time. The remaining 23 patients (with 38 feet) had required anteromedial release; the operative technique is described. Excellent results were uniformly achieved in both groups, with neither recurrence nor complications in the operatively treated feet. There was a consistent correlation between good clinical results and a naviculo-metatarsal angle of less than 100#{176}. The timing of soft-tissue release did not influence the final outcome.

1. Rupture of the brachial artery or of one of its divisions in association with elbow injuries is probably more common than a survey of the literature would imply. Three cases of rupture of the brachial artery complicating compound dislocation of the elbow are reported. 2. These cases appear to have a consistent pattern of soft-tissue damage, with avulsion of the common flexor origin, and a varying degree of damage to the biceps and brachialis. The median nerve escaped injury. 3. The method of dealing with the divided vessels does not appear to be of importance in determining the outcome, simple ligation being as satisfactory as attempts at grafting or suture. 4. In no case was there any evidence of Volkmann's contracture. Provided rapid reduction of the dislocation is effected, together with ligation of the vessels, a satisfactory return of the circulation may be expected.