Background: Radial neck fractures in children are a rare injury, and the timing of surgery as well as the surgical technique will determine how well they respond to treatment. When the tilt surpasses 60 degrees, radial neck fractures in children are signicant injuries with frequent after effects. In these situations, conservative treatment is frequently insufcient, and open reduction may result in iatrogenic consequences. Retrograde intramedullary nailing of the radius is one method of treating dislocated radial neck fractures in children (the Metaizeau technique). Aim: The purpose of this study was to evaluate the functional outcome of Metaizeau technique. Methodology: After taking proper consent and ethical clearance a prospective study was conducted in 16 cases of closed radial neck fractures in children aged 6-12 years without any neurovascular decit. Patients were treated by Metaizeau technique at Jorhat medical college and Hospital from 2021-2022 and were followed up at 2 weeks, 4 weeks, 6 weeks, 10weeks and 12 weeks. Result: In this study, it is found that this technique is safe and effective in treating radial neck fracture in children. The fracture should be reduced within 7 days of injury. Later on, fracture reduction will be difcult because of brosis and fracture healing. In our study, average age was 9 years. Males were affected more than females and the common mode of injury was fall on outstretched hand. All cases achieved radiological and clinical union by 6 weeks. All cases achieved comparable exion-extension of elbow, supination-pronation of the forearm (as compared to healthy side). Average MEPS was 82.19 which was quite remarkable. Only one patient developed entry site pressure necrosis by cut end of TENS nail. The other disadvantage of this technique was need of second surgery for tens removal. Metaizeau technique is a minimally Conclusion: invasive technique with easy learning curve, minimal tissue damage, and reduced chance of elbow stiffness and osteonecrosis of radial head. Our results are within the acceptable range of satisfactory outcomes, if not more towards the better end of the outcomes quoted in literature.

BACKGROUND Thalassaemic children who are on regular blood transfusion are at increased risk of hypothyroidism, growth hormone deficiency, hypoparathyroidism, diabetes mellitus and osteoporosis because of deposition of iron in various endocrine glands with age. Low bone mineral density is a significant problem in these children, which may lead to increased risk for fractures and suboptimal peak bone mass.The aim of the study is to determine the bone health status of children with thalassaemia using quantitative ultrasound densitometry. MATERIALS AND METHODSA case control study was done at Department of Paediatrics, Jorhat Medical College and Hospital, which included 32 regularly transfused thalassaemic children. Age and sex matched healthy controls were included. Quantitative ultrasound bone densitometry was done in both the groups and compared with each other. RESULTSBroadband Ultrasound Attenuation (BUA) and Speed of Sound (SOS) measurements were found to be independent of sex. BUA values in boys showed increasing trend with age, which was not observed in girls. SOS values did not show any increasing trend with age in both sexes. In both the groups, the BUA and SOS increased continuously with increasing age. The values of BUA were more in control group compared to case group while opposite was noticed with SOS values. BUA values were more when ferritin level was >2000 ng/dL and increased number of blood transfusion, whereas SOS values decreased with increase in serum ferritin level and number of transfusion, which was statistically significant (P=0.0125). Both BUA and SOS values decreased with increased severity of malnutrition, which was statistically significant for SOS (P=0.0266). CONCLUSIONQuantitative ultrasound bone densitometry can be used as a screening method to assess the bone health status in children, particularly those with thalassaemia, but requires further studies in large groups.

BACKGROUNDThe aim of the study was to determine the frequency of vitamin D deficiency and insufficiency in children with thalassaemia who were on regular blood transfusion. MATERIALS AND METHODSTotal 25 children were included in this retrospective study in the age group of 2-14 years with confirmed diagnosis of thalassaemia syndrome. They were on regular blood transfusion every 3-4 weeks and they had serum ferritin >1000 µg/L irrespective of chelation therapy. Serum level of calcium, phosphorous, alkaline phosphatase, serum ferritin and 25OH vitamin D were estimated. RESULTSOut of 25 patients, 6 (24%) showed sufficient amount of vitamin D, 6 (24%) showed insufficiency, 10 (40%) showed deficiency and 3 (12%) showed severe deficiency. Children with vitamin D deficiency showed high level of serum ferritin level. Severe vitamin D deficiency was seen when number of transfusions were >20.14 children showed abnormal vitamin D level when their serum ferritin level was between 1000-2000 ng/dL. There was no association between use of iron-chelating agent, duration of their use and nutritional status with vitamin D level. CONCLUSIONIn regularly transfused thalassaemic children, vitamin D insufficiency and deficiency were common and they need frequent monitoring for early detection and management.