It is the intention of the Editorial Board to establish dialogue, discussion, debate and even dispute among our readership and we aim to publish correspondence, however derogatory! With this issue we are adding another contribution to the possibility of debate by having an item called ‘Commentary’ for some of the papers. The commentator will usually come from a different discipline or subspeciality from the original author and will therefore give the matter under discussion a different slant. We hope our commentators will be controversial or will at least produce some new ideas and perspectives. This will give another side to the arguments and discussions of treatment and will also expand particular areas. It is the nature of the article itself which will dictate the content of the commentary. We hope that this will make the journal both more lively and informative.