We describe the results of a policy of highly selective splintage for CDH, using knee plasters. No child suffered because splintage was withheld. In those who were treated the results were satisfactory and the proportion who required a subsequent operation was extremely low. Avascular necrosis was not a significant problem. The method, although a little more time consuming, appears to offer significant advantages over current alternatives.

The results of a study of the use of autograft versus allograft bone in the surgery of idiopathic adolescent scoliosis are presented. Two groups of patients, matched for age, sex, level and angle of curve, received bone grafts, 20 patients having autogenous bone from the iliac crest and the other 20 having donor bone from a bone bank. Both groups had otherwise identical posterior fusions and Harrington instrumentation. There was no difference between the two groups in a blind, radiographic assessment of bone graft mass at six months, nor in maintenance of the curve correction over the same period. No major operative complications nor failures of instrumentation were encountered. There was, however, a marked reduction in operative time and blood loss in the patients receiving donor bone and also a much lower incidence of late symptoms relating to the operative sites. We conclude that, even in the presence of adequate iliac crest, the use of bank bone is superior for grafting in idiopathic scoliosis surgery.

A 15-year-old girl presented with a very large desmoid tumour in her buttock; it extended into the pelvis and thigh and would have required hindquarter amputation for its removal. This was not performed and the tumour underwent spontaneous regression. Fourteen years later the patient is alive and well. The suggestion is made that in some cases a more expectant approach to treatment might be justified for what is essentially a non-malignant condition.