We present the long-term results of pectoralis major transfer to restore elbow flexion in seven patients (ten procedures). The early results in all the patients were encouraging but with longer follow-up a gradual and progressive flexion deformity was observed with a decrease in the arc of flexion in eight elbows, reaching > or = 90 degrees in all cases. The results of pectoralis major transfer deteriorate with time due to the development of a recalcitrant flexion deformity of the elbow. With bilateral involvement we now recommend that the procedure be undertaken on one side only to allow the hand to reach the mouth for feeding, while the opposite side remains in extension for perineal toilet.

The method of insertion of the Herbert screw for scaphoid fractures and its long-term presence in the scaphotrapezial joint may predispose to degeneration in that joint. We examined a group of patients with long-term follow-up to assess this risk and found it to be insignificant.

European Journal of TraumaAb stract Divergent dislocation of the elbow is a rare injury. It is a result of longitudinal disruption of interosseous membrane of forearm. Although it can logically result in disruption of distal radioulnar joint, according to the authors' knowledge this combination has not been reported before. The case of a young gymnast is presented who suffered this injury. She was treated successfully in a hinged external fixator and with stabilization of distal radioulnar joint by a K-wire. She regained almost full range of movement and returned to national level gymnastics.

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