Jean David Lamoureux

Shaft forearm fractures in children: intramedullary nailing with immediate motion: a preliminary report.

Nailing is a good solution for shaft forearm fractures in children who require surgery. A closed reduction is very often possible owing to the bent tip of the pins. The procedure avoids extensive dissection, unlike epiphyseal plates. When a nailing is performed, the distal approach for both bones is the most convenient, avoiding elbow pain on the proximal ulnar incision. Six children of 57 had unacceptable reduction following conservative treatment and underwent intramedullary fixation. An immediate mobilization was possible in all patients. We observed neither delays in union nor recurrent fractures. The range of motion was normal in the postoperative period and at the 1 year follow-up.

Results of surgical treatment of Sprengel deformity by a modified Green's procedure.

The results of treatment of seven children with Sprengel deformity are reviewed. The patients were subjected to a modified Green procedure without dissection of the serratus anterior muscle and immediate postoperative mobilization. The results seem to indicate that the postoperative abduction gain (77 degrees) compares favorably in regard to the current literature and that this modification of the classic technique offers a substantial advantage concerning functional outcome in these patients.

Prevalence of dog bites in children: a telephone survey

The prevalence of non-medically attended dog bite accidents in children is unknown. Dog bite frequencies have been estimated between 9 and 18 per 1000 subjects [1, 2,4]. These figures include both adults and children. As children are at least 3 to 5 times more likely to experience dog bites than adults [2,4], it could be expected that the prevalence of dog bites is significantly greater in children. The data could be useful to set goals for local prevention programmes, as child victims of dog bites may suffer physical and emotional complications [1,3]. A telephone survey was conducted between August and November 2002 in the French-speaking community of Belgium. From an initial anonymous list established by the telephone company Belgacom, the telephone numbers of 8000 families were randomly selected. Families entered the study if they included at least one child under 15 years of age and if parents agreed to answer a questionnaire about family characteristics. If a child had been bitten by a dog during the last 12 months preceding the enquiry, additional questions were asked about the circumstances of the accident and type of medical intervention. The questionnaire had been pretested on 20 families and some questions modified or omitted for lack of clarity. The university ethics committee had approved the study. Of the 8000 telephone numbers randomly selected, 1184 families (14.8%) were included in the study. The other families could either not be contacted (16%) or did not meet the selection criteria. A dog was owned by 398 of the 1184 families (33.6%). Of the 1184 families, 26 reported that a child had been bitten by a dog during the preceding 12 months. The annual prevalence of dog bite was thus 2.2% (CI 1.4-–3.0). Among the 26 children bitten by a dog, 10 presented to a general practitioner, 5 to a hospital emergency department and one child was hospitalised. No child had been bitten on a second occasion during the preceding 12 months and no child died following a bite accident. An annual frequency of 22 bites was determined per 1000 children under the age of 15 years. The findings also support previous observations that far less than 50% of dog bites were reported to medical or legal authorities [2]. The actual incidence of dog bites could still be greater than reported in this survey. Younger families with only portable telephones might not have been reached, while bites from family pets could have been underreported [2,3]. It can, however, be concluded that dog bites represent a significant and underreported portion of accidents in children.

Progressive upper limb lengthening in children: a report of two cases.

A 10-year-old girl presenting with idiopathic humerus varus underwent variation osteotomy of the neck of the humerus followed by humeral lengthening, resulting in 70 mm of lengthening over a 6-week period. Two successive lengthenings of the radius, each approximately 20 mm, were performed on a young girl presenting with radial growth abnormalities, progressively degenerating into a radial clubhand. In both cases, functional and cosmetic improvement followed the surgical procedures, which were devoid of postoperative complications.

Tricho-rhino-phalangeal syndrome type I in a Belgian family

SummaryWe report three cases of tricho-rhino-phalangeal syndrome (TRPS) type I in a Belgian family. They presented typical characteristics such as a pear-shaped nose, and short, deformed fingers with cone-shaped epiphyses of some middle phalanges of the hands. Hair growth was practically normal in our patients, except for some narrowing of the lateral part of the eyebrows. Perthes-like hip dysplasia was documented in two of our cases. The proband presented at the age of 31 with Kienböchs disease of the right wrist. Blood and urine analysis showed no clear anomalies. In this patients, echography revealed a renal cyst containing a stone. The relationship of these findings to TRPS is discussed.