Surgical management of radial head fractures.

OBJECTIVE: To compare the outcome of various surgical options exercised in the management of different types of radial head fractures. METHOD: A retrospective study of 29 patients with radial head fractures managed surgically was undertaken. Case notes were retrieved, and final assessment was performed through a telephone questionnaire. The results were analysed according to the classification of Wesley et al (1983), and compared with the patients' own rating. RESULTS: The best results were obtained in Mason type II fractures, followed by type III and type IV fractures. Comparing different operations, the best outcome was observed with screw fixation, followed by excision of the radial head, Kirschner wire fixation, partial excision, silastic implant, and plating, in that order. CONCLUSION: The less comminuted a radial head fracture is, the better the outcome. Screw fixation is to be preferred, if technically possible. Our method of outcome assessment closely reflected in patient satisfaction

Musculoskeletal involvement in cystic fibrosis.

The purpose of this study was to review the published evidence of the effects of cystic fibrosis (CF) on the musculoskeletal system, and their implications on the quality of life of these patients. With increasing longevity of CF patients, musculoskeletal manifestations have become important. Decreased bone mineral density (BMD) and bone mineral content (BMC) are common at all ages in CF patients, and its cause is probably multifactorial. Risk factors contributing to decreased BMC include age of the patient, imbalance between bone accretion and degradation, body mass, nutrition, activity, exposure to glucocorticoid therapy, and gonadal dysfunction. BMC correlates strongly to fat-free mass in CF patients. Lung transplant, while increasing life span, can worsen osteoporosis. Twenty-nine percent of patients are below the 10th percentile for height. Fracture rates are approximately twofold greater in females aged 16 to 32 years and males aged 25 to 34 years. Female patients aged 6 to 16 have a higher than normal fracture rate and a higher rate than their male counterparts. Spinal consequences of osteoporosis include excessive kyphosis in up to 62% of patients. Back pain was noted in 94% of patients. Arthritis in CF, although less common, can be very incapacitating, and it is mainly of three types: CF arthritis, hypertrophic osteoarthropathy, and arthritis due to co-existent conditions and drug reactions. The treatment of arthritis is mainly symptomatic in the majority of cases

Muscle Length and Joint Range of Motion in Children with Cystic Fibrosis Compared to Children Developing Typically

Purpose: To explore range of motion in children with cystic fibrosis (CF) compared to children developing typically. With the increasing longevity of people with CF, musculoskeletal concerns are becoming more prevalent and should be identified and considered in management plans. Reduced range of motion (ROM) in older people with CF has been demonstrated, and the age at which these changes begin to occur must be explored