Between January 1999 and December 2000, 82 patients who had undergone previous spinal surgery were diagnosed with fibromyalgia. Fifty of the patients completed questionnaires about their medical histories, demographic details, symptoms, quality of life and preoperative and postoperative function. The Medical Research Council performed statistical analysis of the questionnaires.

The ages of the respondents varied, with 70% falling into the 40 to 60-year age group. The majority (80%) were married and reported good to excellent ties with spouse and family. Matriculants made up 76%, and 56% had tertiary education. In 70%, chronic tiredness impaired their daily activity, and 88% reported sleep disturbances. Only 10% believed that surgery had alleviated their neck or back symptoms, and 62% were unhappy with the results of surgery. Before surgery 82% had chronic pain, and after surgery 80% still had pain. Even after treatment for fibromyalgia, 68% still had back pain. There was no significant difference in preoperative and postoperative evaluations of quality of life, and the impact of spinal surgery on function was negative.

The demographic profile of our patients compares with that in the literature. The symptoms of fibromyalgia are diverse and current treatment regimes do not give satisfactory control. In our study, we found that spinal surgery neither ameliorates the symptoms nor improves the poor quality of life of fibromyalgia patients.

We studied the outcome of displaced supracondylar fractures in 98 children treated over three years to December 2000. In 74 patients fractures were treated by closed reduction and percutaneous K-wire fixation. Through a direct posterior approach, open reduction was obtained in the other 24. Postoperatively the elbow was immobilised in a posterior cast in 30° flexion for three to four weeks. The cast and K-wires were removed in the clinic and the elbow mobilised.

In patients treated by closed reduction, the mean range of movement (ROM) was 10° to 120° at the one-month follow-up. There was a cubitus varus deformity in four patients. One patient developed pintract infection. There were five neurological complications, of which only one (ulnar nerve) was surgical. The mean ROM of patients treated by open reduction was 15° to 110° at the one-month follow-up. Pre-operatively two patients in this group had a neurological deficit (one median and one radial nerve), which had improved at follow-up.

Treatment of supracondylar humeral fractures in children by closed reduction and percutaneous K-wires is safe and reliable. Where open reduction is necessary, a posterior approach is more acceptable cosmetically and does not lead to functional loss.