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Surgical reconstruction of the interosseous membrane may restore longitudinal forearm stability in Essex-Lopresti lesions. This study aimed to compare the longitudinal stability of the intact forearm with a single-bundle and a double-bundle reconstruction of the central band of the interosseous membrane using digital image correlation with a three-dimensional camera system. Single and cyclic axial loading of eight fresh-frozen forearm specimens was carried out in the intact state, after creation of an Essex-Lopresti lesion, after a single-bundle and after a double-bundle reconstruction of the central band using a TightRope® (Arthrex GmbH, Munich, Germany) construct. Instability significantly increased after creation of an Essex-Lopresti lesion. The stability of intact specimens was similar to both reconstruction techniques. The results of this study suggest that TightRope® reconstruction of the central band restores longitudinal forearm stability. However, the single-bundle technique may be less reliable than double-bundle reconstruction. Level of evidence: Basic Science Study

Objectives: The aim of this study was understand the treatment itinerary of Brazilian scholar children with Cystic Fibrosis from their perspective and was supported for the medical anthropology framework. Methods: Data was collected through 15 months following with 7 scholar children, both sex, with CF and their families, with the ethnographic method. Data were analyzed with the hermeneutic framework. Conclusion: CF is part of the life experience of the children and so, it’s an important issue of their existence. It has an important role in the decisions of plenty issues like the period of school, the kind of sport that the kid will do and the daily life routine. Most of children did not know clearly what the disease is and nether their treatment and medications names and functions and reported never have been included in his health treatment discussion, what can lead to poor adherence and high dependence to do the daily treatment. Children also have their own explanatory model for the disease and it is different from those of family and CF team, what can lead to truncated communication, understanding and evaluating of the treatment process. Nurses must understand the children perspective about the disease and how their understanding influences their evaluation about the treatment and defines the search for cure. With this we will be able to plan a health care treatment based on the family, children and CF team expectations, with an unified goal that priories the quality of life instead of the disease control.

Long-term anorectal function was assessed in children operated on using Duhamel's technique for Hirschsprung's disease. The files of 75 patients (16 girls and 59 boys) operated on between 1977 and 1991 were reviewed. Questionnaires were analysed on 63 (12 girls and 51 boys) over 2 years of age. The median age at completing the questionnaire was 6.6 years. Forty-one of these 63 patients had aganglionosis of the rectosigmoid, 15 of a long colonic segment, and 7 of the total colon. Of 14 children age 4 or less, 6 had severe constipation, whereas 8 had regular spontaneous defaecation. Ten of the 49 over 4 years of age were continent without constipation, 22 had soiling and/or constipation, and 17 were incontinent, one of whom had a permanent colostomy. There was no correlation between age or sex and anorectal function. Anorectal function in children with long segment was not worse than in those with rectosigmoid aganglionosis, but only 1 of 7 with total colonic aganglionosis was continent. Because many adapt themselves to the handicap, symptoms are often underreported. A detailed questionnaire appears to be a reliable tool for elucidating the real situation. A systematic follow-up of patients with Hirschsprung's disease is proposed to anticipate the complications and to institute proper measures at an early stage.