Hiroshi Nomiyama

Treatment of developmental dysplasia of the hip with the Pavlik Harness: factors for predicting unsuccessful reduction.

To evaluate the risk factors for unsuccessful reduction, we reviewed 100 hips with developmental dysplasia of the hip treated with the Pavlik harness. We divided them into a successful reduction group (reduced without avascular necrosis) and an unsuccessful reduction group (reduced followed by avascular necrosis or unreduced). We compared Yamamuros distance A, the acetabular angle and age at initial application of the Pavlik harness between the two groups. Our data suggest that a Yamamuros distance A of 7 mm or smaller, an acetabular angle of 36 degrees or greater, and an age at initial application of 4 months or older are risk factors.

Five Cases of Car Accident Injuries with Tibial Fractures

Five pediatric cases with tibial fractures which occurred by being run over by a car are reported. All patients were male between ages 5 and 7 years. There were three open fractures of the tibial shaft in which osteosynthesis was performed using K-wires. Three of the five cases also required the use of Neomatrix (artificial dermis) to cover full thicknes skin defects.The artificial dermis formed satisfactory granulation on the bone surface in all three cases. Free skin graft was performed in all five cases. All five fractures healed without infection, with good bone union and a successful skin graft.