[Buenas dias from Nicaragua].
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Forty-one of 55 defect pseudarthroses, most of them with infections, were cured to healing in five years. Autogenic spongiosa proved to be best suitable for soft-tissue repair in cases of non-segmental defects, whereas structured corticalis worked better as a transplant for somewhat stretched and longish segmental defects. Compact osteomyocutaneous free tissue transfer was found to be accompanied by high rates of complications. The tactics of small steps seems to be more promising than anything else for both spongiosa transplantation and corticalis transfer. Fibula-pro-tibia transposition, comparable to the short-distance flap technique, as well as distractive corticotomy should be applied more often, especially to younger patients.
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The nutritional status of 1468 Black preschool children in a rural Eastern Cape area was assessed anthropometrically in order to provide the Department of Health and Welfare with a critical evaluation of the effectiveness of its subsidized skimmed milk powder scheme for local authorities in combating kwashiorkor, to indicate factors which influence nutritional levels, and perhaps to provide a sound theoretical and empirical foundation for future health strategies. Weight and height for age (using the norms of the National Center for Health Statistics (NCHS], weight for height, and triceps and subscapular skinfold thickness were used as criteria for assessing nutritional status. Stated age and certified age groups were assessed separately. Depending upon the sex and stated/certified age, the percentages of children falling under the third percentile ranged from 11,1% to 37,0% for NCHS norms and from 10,9% to 15,7% for skinfold thicknesses. Together with an urban assessment undertaken in December 1982 the survey may indicate where local problems will occur.
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Using surface measurements obtained from anterior-posterior X-rays, the carpal bones on the side of the previous supracondylar fracture were compared with those on the uninjured side. A disparity in growth was found between the two sides. Most often, an increased growth of the scaphoid was seen on the side of the fracture. Analysis of the data obtained from the measurements of all carpal bones did not lead to any definite conclusions. Of the seven carpal bones studied, a greater length (1 to 3 mm.) was found 86 times and a greater width (1 to 4 mm.) 53 times. Decreased length (1 to 4 mm.) was found 63 times and decreased width (1 to 3 mm.) 70 times. A comparison of surface indices indicated an increased growth in 9 to 11 year old children and in 13 to 16 year old children on the side of the broken arm. In patients between 13 and 16 years of age, increased growth (1 to 4 mm.) of the hamate was seen in 10, of the trapezium in 7 and of the trapezoid in 7 patients. Decreased growth was seen most often between 11 and 13 years of age and 13 to 16 years of age. These data indicate a discontinuous and uneven growth in the injured arm that is manifested years after healing of the supracondylar humeral fracture. This study indicates that after healing of the fracture, a temporary growth stimulus is present in some patients. This growth spurt is not limited to the broken bone but is also present far from the fracture in the carpus.