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This study was undertaken because of the large num ber of bicycle accident victims treated in our emergency room. Its aim was to assess the type, frequency, and mechanism of occurrence of bicycle accidents as well as characterization of the type of injuries sustained and the expense incurred by such accidents. One hundred seventy-two patients injured over a 10 month period were studied. The upper extremity was found to be particularly at risk of injury. Fractures accounted for 20% of all injuries. The most common accident mechanisms were being struck by a motor vehicle, falling from a bicycle, or being struck by a bicycle. Eleven percent of the patients studied were pedestrians. Increasing pedestrian-cyclist awareness and modification of currently used protective gloves are proposed to prevent injuries associated with urban cycling.

Twenty-seven consecutive patients with adolescent idiopathic scoliosis underwent posterior spinal fusion with pediatric Texas Scottish Rite Hospital instrumentation. Coralline hydroxyapatite (Interpore, Irvine, Calif) was mixed with limited autograft from posterior iliac crest (an approximate 70/30 ratio of coralline hydroxyapatite to autograft). Patient evaluation was based on clinical and radiographic findings. On initial radiographic evaluation, a "snowstorm" appearance consistent with the exoskeleton of the coralline hydroxyapatite was observed. After two years, the fusion mass had a "marble-like" appearance with distinct decreased visibility of the disk spaces in the fusion mass. This latter stage of "marbilization" correlated with solid fusion clinically. All patients achieved solid fusion at an average follow-up of 27 months. Coralline hydroxyapatite is safe, biocompatible, and effective in augmenting autogenous bone graft in the treatment of idiopathic adolescent scoliosis with posterior spinal fusion. In addition to decreased donor site morbidity, this may be invaluable in cases where there is insufficient autograft available.