Reconstructing elbow instability remains a challenging problem. Techniques described have included techniques for the lateral ligamentous complex, including the lateral ulnar collateral ligament, and techniques to reconstruct the medial collateral ligament. We describe a new circumferential technique to reconstruct both the lateral and medial ligament complexes, using 1 circular graft. A hole is drilled through the center of rotation of the distal humerus and through the insertion sites of the medial and lateral ligament complexes. A hamstring tendon graft is passed through the humerus twice to reconstruct the anterior and posterior bands of the medial collateral ligament and sutured onto itself. Endobutton fixation is used to fix the graft on either side of the ulna. The graft is tightened on the lateral and medial sides and fixed into the humerus using interference fit screws. Advantages of the technique described include stabilization of both the medial and lateral ligament complexes with 1 graft. The strength of fixation allows for individual tensioning in all limbs of the reconstruction and the multiple passes of the graft through a single humeral tunnel increasing the strength of the reconstruction. Potential complications could include ulnar nerve damage, recurrent instability, elbow stiffness, and wound breakdown. Complications related to the potential use of a hinged external fixator are not specific to this procedure but can be associated. Early active mobilization can be initiated because of the strong stability provided by the circumferential graft and good fixation.

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The results of treatment of Mason type-III radial head fractures with a monoblock titanium radial head prosthesis and soft-tissue reconstruction are satisfactory. Early mobilization of the elbow is important for the restoration of elbow range of motion and function.

ONE FIGUREConcerning the circumflex veins of the thigh, the relative infrequency of agreement between the text-book description and the condition seen in the cadaver has led to a reexamination of the mode of ending of these blood vessels. Special attention has been given to the comparison of conditions in the white and the American negro. The manner of termination of these veins has been compared also with the origins of the arteries they accompany.I n the text-books of anatomy the medial and lateral femoral circumflex veins are described as terminating in the deep femoral vein-a relation comparable to the origins of the medial and lateral femoral circumflex arteries from the deep femoral artery ( Cunningham, Gray, Poirier, and Quain). I n both Cunningham and Poirier, however, it is stated that not uncommonly the femoral vein is joined by the medial and lateral circumflex veins. Clear illustrations of the terminations of the medial and lateral femoral circumflex veins are relatively scarce, but in the atlases of Sobotta, Toldt, and Spalteholz the plates show plainly the terminations in the femoral vein. This mode of ending was described by Theile ( '43), and by Picqu6 and Pigache ( '09), who report that in the majority of cases studied by them the circumflex veins terminate in the femoral vein. These investigators also found that the ending of the veins is a t a level proximal to that of the origin of the corresponding circumflex arteries.

ONE FIGUREThe variance between the descriptions of the terminations of the medial and lateral circumflex veins of the thigh given in the textbooks of human anatomy, and the modes of termination found in student dissections at Washington University, led to the stucly of the conditions