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When open-book injuries are neglected and result into a pelvic malunion or nonunion, long-term problems, such as chronic pain, gait abnormalities, sitting discomfort, neurological symptoms and urogenital symptoms can occur. In this case report, we describe the repair of a neglected pelvic disruption with the dislocation of the urinary bladder in a one-stage procedure. The clinical image with which the patient presented could be split into unique sub-problems, for which separate solutions needed to be chosen: large symphysis diastasis, instability and pain in both SI joints, malunion of the superior and inferior pubic rami fractures; and urinary bladder herniation into the upper thigh. In a single-stage procedure, the pelvic ring was reconstructed and the bladder reduced. The patient was thereafter continent for urine and could walk independently. A complex clinical problem was divided into its sub-problems, for which specific solutions were found.

Congenital nevus spilus is rare, and the lesion is usually small. This report describes an 8-year-old girl with a giant congenital nevus spilus that involved the left side of her abdomen, perineal area, and left upper thigh. The patient also had a Mongolian spot in the lumbosacral area.

Wound areas on the upper thigh following split thickness skin grafts can be standardized. They are, therefore, suitable as wound models for comparative investigations into the kinetics of epithelialization using various wound therapeutic agents. In a prospective clinical study, the epithelialization time in two split thickness graft donor sites was examined in an intraindividual comparison on 16 patients. Zinc oxide and potassium/calcium chloride hydrogel were used as the comparative substances. The results confirm the suitability of the study design for the testing of efficacy of topical wound therapeutic agents. The model can be standardized, is practical, and does not require additional stress to the patient.

Transcutaneous bilirubinometry (Yamanouchi & Minolta Co.) has been shown to be useful in predicting serum bilirubin concentration in Japanese, white & black term infants (Yamanouchi, Lucey & this author). The same methodology was used to test its validity in 2 groups of preterm infants (Gr.A: No. 11, Wt. 750-1500 gm, 50 determinations, age 20 hrs-19 days, serum Bil. by alkaline AZO method 2.5-18.5mg%, Gr. B: No. 17, Wt. 1500-2500 gm, age 25 hrs-10 days, 50 determinations, serum bilirubin 1.2-14.2mg%). Gr.A showed best correlation at upper thigh (r=0.87, p < 0.001, standard error of estimate 1.87) while Gr. B had best correlation at forehead (r=0.82 p < 0.001, standard error of estimate 1.74). Since most primies are born with fair skin which turns darker after exposure to daylight, it was assumed that Tc bilirubin reading at exposed & covered skin (a piece of aluminum foil 1 inch in diameter was patched on 1 thigh since birth) will be different. A simultaneous Tc bilirubin reading was obtained from the covered & exposed thigh on the 4th & 5th day in 6 preterm infants (Wt. 1245-1400 gm). 17 Readings were made on the covered area with a mean of 17.22 & SD of 1.34. The mean-reading on the exposed thigh was 17.50 with SD of 2.24. The student paired T test revealed no statistical significance of the readings from the 2 sites. Since the number is too few at this stage, more data will be needed to confirm this study.