Bilateral asynchronous humeral shaft fractures in a patient with autosomal dominant osteopetrosis type II (Albers-Schonberg disease).

Osteopetrosis is a rare metabolic disease which presents with fragile osteosclerotic bone. A thirteen-year-old girl with an underlying autosomal dominant osteopetrosis (ADO) type II who sustained a left oblique humeral shaft fracture after trivial trauma is presented. Radiographic results showed many characteristic features of osteopetrosis, including incomplete remodeling of a previous fracture of the contralateral humeral shaft. The authors obtained good healing and alignment of the left humeral shaft fracture by sugar tong slab.

Scurvy in pediatric patients: a review of 28 cases.

OBJECTIVE: To study the dietary factors, clinical findings, plasma vitamin C level and post-treatment outcome of scurvy in pediatric patients at Queen Sirikit National Institute of Child Health. STUDY DESIGN: A retrospective study. METHOD: The medical and radiographic records of pediatric patients, diagnosed with scurvy at Queen Sirikit National Institute of Child Health from 1995 to 2002 were reviewed. RESULTS: Twenty-eight pediatric patients were diagnosed with scurvy. Their ages ranged between 10 months-9 years 7 months (median age of 29 months). 93 per cent of the cases were between 1-4 years of age. All were fed with well-cooked foods and small amounts or no vegetables and fruits. Supplementation with ultra heat temperature (UHT) milk was found in 89 per cent, average 5.8 boxes/day and 14.3 months in duration. Eighty-six per cent of cases were misdiagnosed previously. Clinical manifestations involved limp or inability to walk (96%), tenderness of lower limbs (86%), bleeding per gum (36%), fever (18%), and petechial hemorrhage (3.6%). All cases had abnormal radiographic findings compatible with scurvy and 2 cases had epiphyseal separation. All had clinical improvement within the first week after vitamin C supplementation. CONCLUSION: Vitamin C deficiency was found in the children's intake of small amounts or no vegetables and fruits together with UHT-milk. Frequent manifestations were limping and inability to walk and pain in the lower limbs. Response to vitamin C treatment was dramatic.

Causes of femoral shaft fracture in children under five years of age.

OBJECTIVE: To study the causes of femoral shaft fracture in children younger than 5 years of age. STUDY DESIGN: Retrospective, descriptive study. PATIENTS AND METHOD: Medical records and radiographs of 39 children younger than 5 years of age with femoral shaft fractures treated in Queen Sirikit National Institute of Child Health during the years 1996-2001 were reviewed. The responsible causes for the femoral shaft fracture given by caretakers by interview were collected. RESULTS: The most common history was falling or jumping from a height (36%) followed by traffic accidents (26%) and object or person falling on top of them (23%) respectively. Only one case presented with a history of abuse. Nine cases were suspected of abuse, but, without further investigations it was not possible to identify the exact cause of fracture. CONCLUSION: Histories given by caretakers for the cause of femoral shaft fracture in children younger than 5 years of age are varied. The orthopedists should find out the exact cause of fracture to prevent missed or delayed diagnosis of abuse that may have occurred.