Recurrence after Achilles tendon lengthening in cerebral palsy.

We performed a retrospective review of all hemiplegic and diplegic cerebral palsy (CP) patients who had tendo-Achillis lengthening by open Z-plasty between 1974 and 1985. Fifty-seven patients with 77 heelcord lengthening were followed approximately 10 years. Our postoperative regimen did not routinely include bracing and physiotherapy, but our recurrence rates of 18 and 41% for diplegic and hemiplegic patients, respectively, are comparable to those reported in the literature. Children aged > or = 6 years at initial operation did not have recurrence. Diplegic patients who were operated on before age 4 years or patients who had longitudinal incisions had statistically significantly higher recurrence rates.

Vehicle-moose accidents in Newfoundland.

During 1987 and 1988, in Newfoundland, there were 661 motor-vehicle accidents involving a moose; 133 people were injured and three died. This constitutes a major problem for the provincial health-care system. In 95 per cent of the patients who were involved in fifty-five primary collisions (the vehicle hit only the moose), the injury-severity score was less than 9 (mean and standard deviation, 3.2 +/- 4.6). There were thirty-six secondary collisions: in eighteen, the vehicle hit other objects after avoiding the moose (group A), and in the other eighteen, the vehicle hit the moose and then hit other objects (group B). In group A, the mean injury-severity score was 4.2 +/- 2.9 and in group B, it was 19.6 +/- 27.1. The three patients who died were in group B. There were more injuries to the thorax, thoracolumbar spine, and abdomen in group B than in the single-collision groups (primary-collision group and group A).