The methods of preoperative orthopedics: a "T-traction" procedure for unilateral clefts and a combined premaxillary pressure and expansion procedure for bilateral clefts and of early alveolar bone grafting: the Nordin's "four-flap" technique, are described in detail. The subsequent effects of treatment according to those methods were studied with roentgencephalometric analysis in cleft patients from 7 to 13 years of age. They were divided into two unilateral and one bilateral complete cleft group, all having been early bone grafted. The unilateral groups were composed of one group of 39 children operated on during the period 1960-65 without preoperative "T-traction", and another group, of 46 children, operated on in 1965-72 after preoperative "T-traction". The bilateral group included 19 children operated on 1960-72 after preoperative orthopedics. The same degree of inhibited development of the facial skeleton as found in another Swedish early bone grafted cleft group was not present in our patients. The development of the skeletal profile in our bone grafted cases, especially those in the "T-traction" group, was well within the limits of non-grafted U.S. cases, but differed from non-clefts.

Direct wound closure with or without flap-plasty after vulvectomy gives satisfactory cosmetic and functional results. Split thickness skin-grafts seem to be of limited value in the repair of the defects.

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Defects after excision of large pilonidal sinuses were reconstructed by either rotation skin flaps or a Z-plasty technique. Altogether, 16 patients were operated on, 10 with a rotation flap and 6 with a Z-plasty technique. All the patients except one underwent a radical operation. The patient not having a radical operation had a recurrence. Two cases in the Z-plasty groups acquired an infection in the distal part of the wound necessitating reoperation on the resultant sinus. The disability after this more extensive surgery was not more pronounced than after ordinary surgical procedures. For large recurrent pilonidal sinuses, radical excision and primary suturing of the wound using a rotation flap is recommended as the method of choice.

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The technique and results of using autografts of dermis to repair defects in the anterior abdominal wall is shown. Dermal grafting was used in altogether 15 cases. 7 with extremely large incisional hernias, and 8 with defects after malignant abdominal wall tumours. The surgical method is described and the follow-up 1 to 4 years postoperatively has shown a very satisfactory result in 13 cases. In one case there was a postoperative haematoma with subsequent graft necrosis and in the other there was a residual hernial defect. We recommend this method as one of choice in cases with large abdominal wall defects.