Delayed identification of an isolated paediatric capitate fracture.

Fractures of the capitate bone are the second most common injury to a child's wrist but are rarely encountered in isolation. This is reflected in the paucity of described cases in the literature. Their true incidence is unknown as they often do not appear on plain radiographs and may heal without immobilisation. The easiest way to detect these fractures is with an MRI scan. The authors present a rare case of isolated capitate fracture that was initially missed on plain films. This case is important as it highlights the need for a high index of suspicion in paediatric patients with unresolving wrist pain.

Cervical spinal abscess: an insidious presentation and unusual pathology.

Spinal abscess is a rare condition. Its presentation can often be subtle and insidious. This report describes the diagnosis and management of an 87-year-old man who presented to our orthopaedic clinic. We would like to emphasise the importance of rapid diagnosis and prompt treatment in such cases.

Bone mineral density in beta - thalassemic Lebanese children.

Osteoporosis has been described extensively in adult thalassemics. Fewer studies have been reported in thalassemic children. In this article, we measured the bone mineral density (BMD) of Lebanese beta-thalassemic children before institution of a balanced transfusion-chelation regimen, in comparison with that of healthy controls, and studied its correlation with various demographic and biological parameters. Both groups, controls and thalassemics were comparable with respect to age, sex, socioeconomic and regional distribution. On the other hand, thalassemics had a significantly lower height age (p<0.001), lower bone age (p=0.001), lower sexual maturation (p=0.004), lower absolute BMD values and larger negative BMD-Z scores (p<0.001). Within the thalassemic group, BMD correlated significantly with luteinizing hormone (LH) and follicle stimulating hormone (FSH), estradiol and testosterone values, as well as with the pretransfusion hematocrit, but not with other endocrine or bone metabolism parameters. We conclude that Lebanese beta-thalassemic children have a significantly lower BMD than their healthy counterparts due, in part, to their slower physical development. A major contributor seems to be the low-transfusion regimen followed by these patients, as well as the endocrine dysfunction which was detected in about 25% of them.