BMPER variants associated with a novel, attenuated subtype of diaphanospondylodysostosis.

Diaphanospondylodysostosis (DSD), caused by loss of bone morphogenetic protein-binding endothelial regulator (BMPER), has been considered a lethal skeletal dysplasia characterized by severe deficiency of vertebral body and sacral ossification, reduced rib number and cystic kidneys. In this study, however, we have demonstrated that variants in BMPER may cause a milder disorder, without renal anomalies, that is compatible with long-term survival. Four siblings, three males and one female, presented with severe congenital scoliosis associated with rib and vertebral malformations as well as strikingly delayed ossification of the pedicles.

The use of tissue sealants to deliver antibiotics to an orthopaedic surgical site with a titanium implant.

Background: Orthopaedic surgery is associated with unacceptable infection rates that respond poorly to systemic antibiotics. The objective of this study was to use an animal model for orthopaedic implant infection to examine the ability of a new-generation fibrin tissue sealant to effectively deliver antibiotics to the surgical site.

Methods: The antibiotics cefazolin, fusidic acid or 5-fluorouracil were blended into Vitagel tissue sealant.

Inter-observer and intra-observer agreement in the radiographic diagnosis of avascular necrosis of the femoral head following slipped capital femoral epiphysis.

Introduction: Slipped capital femoral epiphysis (SCFE) is a common pediatric hip disorder. Avascular necrosis (AVN) of the femoral head is a devastating complication of SCFE. The frequency of this complication reported in the literature has been variable.

The effect of surgical timing on operative duration and quality of reduction in Type III supracondylar humeral fractures in children.

Purpose: To determine the influence of the time from injury to surgery of Type III supracondylar fractures on operative duration and quality of reduction.

Methods: A retrospective review of Type III supracondylar fractures treated by closed reduction and percutaneous pinning over a 3-year period was performed.

Results: The subjects were divided into two groups based on the time from injury to surgery (IST): Group 1 (<8 h) 48 subjects and Group 2 (>8 h) 39 subjects.

Improving health services to displaced persons in Aceh, Indonesia: a balanced scorecard.

Problem: After the Indian Ocean tsunami in December 2004, the International Organization for Migration constructed temporary health clinics to provide medical services to survivors living in temporary accommodation centres throughout Aceh, Indonesia. Limited resources, inadequate supervision, staff turnover and lack of a health information system made it challenging to provide quality primary health services.

Approach: A balanced scorecard was developed and implemented in collaboration with local health clinic staff and district health officials.