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Reports of accessory soleus muscle are rare, perhaps as a result of it often remaining unrecognized. It presents as a swelling behind the ankle and may be mistaken for a tumour or inflammatory lesion, as occurred in the first of a series of three cases. The other two were incidental findings, one in a 30 year old man with an open tibial fracture and the other in a 9 month old child with a club foot. Patients present with either pain or a diagnostic problem. When large, it may make wearing of footwear difficult. Computerized tomography with electromyography enables confirmation of the diagnosis. Pain is relieved by epimysiotomy and when encountered incidentally during surgery, incision of the epimysium is all that is needed. Excision of the muscle may be considered only if wearing of footwear is difficult. The significance of its presence in a case of club foot is unknown. Disinsertion of its insertion was all that was required to obtain surgical correction of the deformity in the present case. Awareness of the condition will prevent unnecessary surgery in asymptomatic cases.

Study Design Efficacy of the percutaneous biopsy of the spine under computed tomographic guidence was investigated, Seventy-five patients, ranging in age from 7 to 72 years, underwent this procedure. Objectives To determine the usefulness of computed tomographically guided biopsies in the treatment of patients with spinal disorders. Summary of Background Data The results of 68 biopsies (90.6%) were judged to be accurate insofar as the samples of tissue obtained could be diagnosed as specific types of enoplasm, infective lesions, reactive lesions of nonspecific type, or noramal bone. Methods Biopsies that yielded a specific abnormality were categorized as true positives. The “normal” biopsies were followed for 6–8 months and were than deemed true negatives. Nondiagnostic ones were considered false negatives. Results The results are acceptable with an accuracy rate of 90.6%. It is a safe and simple procedure with a short learning curve. Conclusions Computed tomographically guided biopsy of the spine is recommended as a procedure of choice, especially in cervical and thoracic lesions. Computed tomography is superior to fluiorascopy when dealing with small, deep-seated lesions especially in the cervical and thoracic regions and with lesions picked up on bone scan only, radiographs being negative. Needle biopsy under computed tomographic guidance is safe and precise.

Two cases of metachronous multicentric giant cell tumour of bone are reported. One patient had tumours in the tibia and the femur, the second tumour appearing five years after the first. The other patient developed tumours in the tibia and the radius, the second tumour appearing two years and nine months after the first. The metachronous tumours, in both cases, were clinically and radiologically more aggressive than the initial tumours. Treatment with curettage and bone grafting proved to be ineffective for these tumours and en-bloc excision was required for cure.

We have used the extensor digitorum brevis musculotendinous unit elevated on its neurovascular pedicle and transposed it to reconstruct the Achilles tendon in a case of neglected rupture.