No abstract

Thirty-eight children in whom a peripheral nerve injury of the hand had been repaired from 2 to 18 years earlier (mean 7.5 years) were examined. All repairs had been performed with the conventional technique with epineural sutures, and nearly all were primary neurorrhaphies. Sensory recovery was evaluated by using the two-point discrimination test (2 PD). The results were considered good if the 2 PD value was less than 6 mm and poor if this value was more than 15 mm. Of the 20 repairs of an ulnar or median nerve, or both, results were good in eight (40%), fair in 10 (50%) and poor in two (10%). Of the 18 digital nerve repairs, results were good in 14 (77.8%) and fair in four. The results in this series are better than results reported for adults series.

The treatment series comprised 96 children with flexor tendon injuries of the hand. Sixty-one per cent of the injuries were in no-man's land. About one half of the patients had tendon severances of the little or ring fingers. The flexor tendon was sutured in 57 hands (59%) and grafted in 37 hands (39%). Tendon transposition was performed in two hands (2%). A total of 84 children were reexamined after a mean follow-up of 8.5 years. Of 53 hands in which direct tendon sutures had been done, either as a primary, delayed or late procedure, results were good in 46 (86.8%), fair in five (9.4%) and poor in two (3.8%). Of 30 free tendon grafts performed on 29 patients, results were good in 14 fingers (46.7%), fair in 10 (33.3%) and poor in six (20%). We recommend primary suture of a divided profundus tendon at any level. A cut superficialis tendon in no-man's land should be excised, if the surgeon is not a skilled hand surgeon. In our experience suture of the flexor tendon, performed at any level, gives better results than grafting.

Traumatic bowing of the forearm or lower leg is reported in 31 children. It is a relatively rare condition. Bowing occurs most frequently in combination with fracture of the other bone in the same extremity. In a minority of cases a bowing deformity is a single lesion. Age distribution, degree of deformity, mechanism of origin and therapy are presented and discussed.

A case of bursitis calcarea trochanterica acuta is reported in a boy aged four months. The calcification was amorphous, and arthrography revealed extension into the hip joint. The lesion was treated surgically.