Background: The child presenting with quadriceps femoris/contracture that is resistant to serial manipulation and plaster casting and the older child with a fixed contracture of the quadriceps is treated surgically at the African Inland Church-Cure International Children's Hospital. The surgery involves soft tissue release and lengthening of the quadriceps tendon. Open reduction of the knee and femoral osteotomy is done as indicated. Objective: To analyze the outcome of surgical treatment of quadriceps femoris contracture in children. Setting: AIC-CURE International Children's Hospital in Kijabe, Kenya. Methodology: This is a review of files of children in our hospital treated surgically for quadriceps fibrosis over a period of three years (January 2005 to December 2007). Results: There were fifty one cases of quadriceps fibrosis in thirty six patients treated surgically over the study period. Thirty one cases were excluded due to incomplete records or patients lost to follow-up. Consequently, the remaining twenty cases were analyzed. The pre-operative range of motion of the knee was grouped as follows: two cases had dislocated knees, three had hyperextension contractures, thirteen (0-30 degrees) and two (31-60 degrees). The final post-operative range of motion was grouped as follows: three (0-30 degrees), four (13-60 degrees), three (61-90 degrees), one (91-120 degrees) and nine (full range of flexion). Gain in flexion ranged from minus forty degrees to positive 140 degrees. The average gain in flexion was 94.7 degrees. Five patients underwent a second procedure to improve flexion. Soft tissue complications developed in four cases. Conclusion: Quadriceps femoris/contracture responds well to surgical treatment with an expected gain in flexion of 94.7 degrees. The commonest complication is skin breakdown.

The thoracic pedicle is generally cylindrical with various  indentations on its surface that may introduce an error in measurements, thus making the measurements unreliable. One hundred and eighty thoracic pedicle diameter measurements were carried out in five cadaveric human thoracic spine specimens, using a Vernier caliper. Coefficient of variation (CV) was used to evaluate the variation in measurements within and between  pedicles. Linear regression model was used to evaluate the  relationship between the variation in measurements and the average diameter of the bone per cadaver. The largest standard deviations in the five specimens were found at T2, T3, T6 and T12 levels. The least standard deviations were found at T1, T7, T9, T10 and T11. Four specimens demonstrated a negative linear relationship between the coefficient of variation and the average transverse diameter of the pedicle. This relationship was  significant (p<0.05) in two specimens. Vernier caliper measurements tend to be less reliable as the thoracic pedicle transverse diameter decreases. Caution is required when measuring the thoracic pedicle transverse diameter in the narrower mid-thoracic area of the spine with Vernier calipers.Keywords: reliability, thoracic pedicle morphometry