Results of treatment and complications of fractures of the neck of the femur in children

Sixty children, 3 to 17 years old, with fractures of the femoral neck were treated in this series, but only 37 cases attended the final follow up. The average period of follow up was 2.4 years. One fracture [1.7%] was transepiphyseal, 19 [31.7%] transcervical, 38 [63.3%] cervicotrochanteric and 2 [3.3%] were intertrochanteric. Five cases received no treatment at all, four undisplaced fractures were treated by immobilization in a hip spica, eight of the displaced fractures were treated by closed reduction and cast immobilization, 23 by open reduction and internal fixation and 20 cases by McMurray's displacement osteotomy. The results were: 29.7% good, 37.8% fair and 32.4% poor. Open reduction and internal fixation by two cancellous screws was found to give the best results in treatment of displaced transcervical and cervicotrochanteric fractures. The complications and factors affecting the results of treatment are discussed

Treatment of fractures of the olecranon by tension band wiring

44 cases of separated fractures of the olecranon were treated by the tension band wiring technique. The fracture line was transverse in 50% of the cases, oblique in 34%, comminuted in 13.6% and fracture dislocation of the elbow in one case [2.3%]. The average period of follow up was 18.7 months. The results were 68.3% excellent, 11.3% good, 9.1% fair and 11.3% poor. The average time for healing of the fracture was 6 weeks in 70.5% and 6-9 weeks in 20.9%, only 3 cases ended with non-union. 90.9% of the cases regained full flexion of the elbow and 61.4% regained full extension. Complications and factors affecting the results are discussed

Ewing's sarcoma of the first metacarpal bone: a case report

An unusual case of Ewing's sarcoma of the first metacarpal bone is reported. There were no systemic reactions or leucocytosis. The tumour grew slowly for one year. The rediographic appearance differed from those encounterd in Ewing's sarcoma of the long tubular or flat bones. The response to rediotherapy was satisfactory

Congenital bony tarsal coalitions in the pathogenesis of the spasmodic valgus foot syndrome

The role of congenital tarsal fusions, mainly the talocalcanean bridge and calcaneo-navicular bar, may play in the pathogensis of the spasmodic valgus foot syndrome had been investigated. Seventy-nine patients with affection of 121 feet-were found suitable for inclusion in this study. Some authors considered the two conditions as cause and effect. This was refuted by the findings in this series, as those of other authors. Tarsal coalitions were not present in all cases of spamodic valgus foot, only 31.4% in this series. They may exist without producing sympotoms; 10.5% in the present study. When present they bore no constant relationship to the severity of the symptoms. In was thus concluded that congenital tarsal coalitions, per se, were not capable of producing the clinical syndrome of spasmodic valgus foot. They may however, precipitate early degenerative changes of the major tarsal joints. This may weaken the affected foot which then becomes more liable to the effect of trauma or even normal usage or prolonged standing. This is evidenced by the fact that most of these patients are adolescents or adults employed in jobs which entail prolonged standing, and that the symptoms were noted to have started soon after they commenced their particular work. This view, however lacks confirmation from controlled comparative study of a big series of cases of asymptomatic congenital tarsal fusions