The aim was to assess the effect of caudal block on patients who have had proximal femoral &/or pelvic osteotomy compared to patients who have had epidural anaesthesia with regards to pain relief and hospital stay.

We looked at two patient cohorts; epidural & caudal pain relief in aforementioned procedures. Interrogation of our clinical database (WinDip, BlueSpeir&clinical notes) identified 57 patients: 33 proximal femoral osteotomy, 13 pelvic osteotomy and 11 combined(25 Males 32 Females), aged 1–18 years-old between 2012–2014, in two institutions. A database of demographics, operative indications, associated procedures, analgesia and type of anaesthesia was constructed in relation to daily pain score and length of hospital stay. 39 patients had epidural anaesthesia, and 18 had caudal block. Cerebral palsy with unstable hips was the commonest indication(21), followed by dysplastic hip(10), Perthes disease(8) and other causes(18). The Face, Legs, Activity, Cry, Consolability(FLACC) scale was used to assess pain.

Length of hospital stay in caudal block patients was 3.1 days(1–9), in epidural anaesthesia patients stay was 4.46 days(2–13). Paediatrics high dependency unit after an epidural was needed in 20(Average stay 3.4 days) compared to 1 who received caudal block. Caudal block FLACC pain score in the first 36 hours was 1.23(0–4) compared to 0.18(0–2) in patients who had an epidural.

Caudal block is associated with less hospital stay and fewer admissions to the high dependency unit, it also provides adequate pain relief post osteotomies when compared to epidural, therefore could be performed at units lacking epidural facilities. A change in related practice however should be cautious and supported by further studies.

Purpose Of Study: To evaluate the results and functional outcome of use of three lateral K wires in supracondylar fracture fixation in children.

Methods And Results: It is a prospective study of 25 cases of supracondylar fractures over a period of three years from 2001, in children between 2 to 9 years, comprising of closed manipulation and percutaneous fixation with 3 lateral K wires, all done by the same surgeon.

Patients were immobilised for 3 weeks and K wires removed at that time. They were followed up till they regained full range of movements in the elbow.

Of the 25 cases, 2 were previously fixed with crossed K wires and were revised because of displacement . One patient had a delayed fixation because of gross swelling and was initially managed with traction.

Pin tract infection was noted in one case and responded to antibiotic therapy.

All the patients regained full range of movements and no angulatory deformity or loss of fixation was noted at the end of follow up.

Conclusion: Fixation with three lateral K wires is an excellent technique in treating displaced supracondylar fractures in children.