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Current methods of measurement were reassessed by the study of tibial torsion in 1000 normal legs using the tropometer, the caliper and X-rays. No significant difference in the reproducibility of results was found and the simpler clinical methods appeared to be satisfactory for practical purposes. The spontaneous evolution of leg torsion in clubfoot was studied in forty-two neglected and previously untreated cases, who were seen for the first time after they had begun walking. Comparison with the torsion observed in the legs of healthy children of a corresponding age proved that untreated clubfoot is not associated with pathological torsion. The place of rotation osteotomy in the treatment of clubfoot is discussed.

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Thirty-two neglected congenital dislocations ofthe hip in twenty-two children over the age ofsix years were treated by traction, open reduction and Chiari osteotomy. In five hips, where prolonged traction failed to bring the femoral heads into the vicinity of the acetabulum, a shortening subtrochanteric osteotomy of the femur was performed. The overall results were good and this regime of treatment is recommended. The best approach to congenitally dislocated hips is early detection and treatment. Unfortunately, in less favoured populations the dislocation is usually only discovered when the child starts to walk. Even then, orthopaedic treatment is sometimes unavailable and has to be delayed until thc family migrates or a new surgical team arrives.

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