Twelve closely related members of one family were found to have small or absent patellae. Seven of these patients also had abnormalities of the pelvic girdle and upper femora. There was a resemblance to the nail--patella syndrome in the patellar abnormalities but not in the associated conditions, and it would therefore appear that the syndrome described is a new variety of congenital abnormality of the knee.

1. A method of treatment of the congenitally dislocated hip is described. 2. The rationale of the treatment is considered. 3. The subsequent development of the hip generally, and of its individual components, is described. 4. Comparison between the results of other methods of treatment and of this method is not attempted for reasons stated. 5. The advantages of a shortened period of splintage are discussed. 6. The state of fifty completely dislocated hips treated consecutively is described at the end of a follow-up period of from three to seven and a half years.

The initial lesion in infections of the hand consists of a group of organisms surrounded by an area of reaction. As in all infections, subsequent events depend upon the result of a conflict between the general and local resistance ; and upon the type, virulence, and number of the invading organisms. In fascial space infections the lesion consists of three distinct zones: a) a central zone with pus under tension-the result of death of cells at the site of entry of the invading organisms; b) a middle zone of tissues not yet transformed into pus but already undergoing INFECTIONS OF THE HAND

In congenital dislocation of the hip three essentials for good results are early diagnosis,

1. A series of 196 fractures of the patella has been reviewed. 2. The treatment adopted was excision of the whole bone—l0l; excision of part of the bone—33; open reduction and suture—18; suture with later excision—14; no operation—30. 3. The average time of post-operative disability varied from 3·6 to 5·3 months. The time was appreciably less when operation was carried out before the fourteenth day than when it was done later. 4. An attempt was made to follow up, two to five years after injury, those patients in whom the result was not influenced by other major injuries of the limbs or by unexpected complications. Replies to questionnaires were received from 116 patients. 5. Of these, all regained a good range of movement, varying from 90 degrees of flexion to full movement, whether treatment was by excision of part or all the bone, or by open reduction and suture. 6. The late results of excision of the patella, as estimated by the patients themselves two to five years after treatment, showed that there was considerable residual disability. 7. After total excision of the bone only 5 per cent. of patients considered that the knee was normal; 90 per cent. complained of aching; 60 per cent. complained of "giving way." After excision of one fragment, about half the patients regarded the knee as normal and half complained of aching and stiffness. 8. The number of fractures in this series treated by accurate internal fixation was too small to make justifiable comparisons. 9. The indications for non-operative treatment, open reduction and accurate internal fixation, excision of one fragment, and excision of the whole bone are discussed. 10. Excision of part or all the patella is often inevitable, but some claims made in the past for the results of this operation are not substantiated.