Tang-Kue Liu

Sleeve fracture of the patella in children A report of five cases

pole.’ This is an uncommon type of fracture in children. Very few reports could be found in the literature. 4,7,9,12 From March 1984 to February 1988, we treated five patients with sleeve fracture of the patella. There were four boys and one girl, ranging in age from 8 to 12 years (mean, 11.2 years). The follow-up period ranged from 21 to 67 months (average, 22 months). All of the patients had the same mechanism of injury; they participated in sports that require jumping with sudden forceful extension of the takeoff knee (Table 1). Upon injury, sudden giving way with

Limb lengthening over an intramedullary nail. An animal study and clinical report.

With the goal of reducing the duration of external fixation in limb lengthening, the authors investigated the feasibility of limb lengthening over an intramedullary nail that could be statically locked when the desired length was achieved, permitting early removal of the external fixation device. In a preliminary study, 8 minigoats underwent 2.0-cm lengthening of the tibia by means of a uniplanar external fixator. Half of the goats had a reamed nail placed in the tibia at the initial surgery. By 10 weeks after lengthening, there no difference in radiographic, histologic, or biomechanical evidence of bone regeneration was found between the tibiae that were nailed and those that were not. In a following clinical series, 15 patients underwent tibial or femoral lengthening by means of a circular frame fixator with a reamed intramedullary nail in place. The postoperative course was uneventful except for 1 infection. The distraction gaps became ossified from 6 months to 1 year, and only 2 patients needed additional bone graftings. The joint function of the lengthened limb at last followup was good. Gradual limb lengthening with a reamed intramedullary nail in place is safe and effective and allows for early removal of the external fixation device.