A Case Report of Sleeve Fracture of the Patella in a Shield.

INTRODUCTION: Sleeve fractures of the patella are rare fractures that only occur in children. The diagnosis is difficult both clinically and radiologically since the distal bony fragment may be too small to be detectable by radiography. A high-riding patella and hemarthrosis are important signs of sleeve fractures. CASE REPORT: A 12-year-old boy was admitted to the emergency room after having felt a severe pain in his left knee on kicking the ground while skateboarding earlier that day. Knee swelling, tense hemarthrosis, and periarticular tenderness were noted. On physical examination, an extension lag of 15 was observed. The active range of motion of the injured knee was 45-90° of flexion. Radiography showed an avulsion fracture of the lower pole of the patella and a high-riding patella. At the next day after the injury, we performed open reduction and internal fixation surgery. Open reduction with transosseous tunneling and cerclage wiring was performed because the distal bony fragment was too small for tension band wiring to be used. At 9 months after surgery, there was no extension lag, and the active range of motion of the injured knee was 0-140° of flexion. Callus formation over the fracture site and bone union was confirmed, and the cerclage wire was removed. To date, he had no further symptoms and has been able to carry out all types of physical activities, including skateboarding. CONCLUSION: Although sleeve fractures in children are uncommon, it should be considered a possibility in children with a chief complaint of pain around the knee. Open reduction and internal fixation was effective in the treatment of sleeve fracture of the patella.

Volar perilunate trans-scaphoid dislocation: a case.

We report a rare case of volar perilunate trans-scaphoid dislocation that was treated with open reduction and internal fixation.

Intra-articular nodular fasciitis of the knee: a rare cause of recurrent hemarthrosis.

A 20-year-old man presented with pain and recurrent hemarthrosis in the right knee. Magnetic resonance imaging of the knee showed a lesion with homogeneous low signal intensity on T1-weighted images and a heterogeneous, low to high signal intensity on T2-weighted images. At arthroscopy, the mass was located between the posterior cruciate ligament and the posterior knee joint capsule. The tumor was excised through a posterior approach and histologically diagnosed as a nodular fasciitis. Intra-articular nodular fasciitis is a very rare clinicopathologic entity. The current case showed the unique clinical feature of recurrent hemarthrosis at initial presentation, which has not been previously reported.

The effect of bevacizumab on tumour growth of malignant fibrous histiocytoma in an animal model.

BACKGROUND: Bevacizumab is a specific inhibitor of angiogenesis and a neutralising antibody against vascular endothelial growth factor (VEGF). The effect of bevacizumab was evaluated on malignant fibrous histiocytoma (MFH) in vivo using an animal model. MATERIALS AND METHODS: MFH cell line, NaraH, was implanted to athymic nude mice which were randomly divided into a treatment and a control group. The change in body weight and tumour volume were evaluated and immunohistochemical analysis was performed of microvessel density (MVD) and VEGF expression in the tumour tissue. RESULTS: Bevacizumab significantly induced inhibition of tumour growth, reducing tumour volume to 48% at the end of experiment. Intratumoural MVD was significantly decreased in the bevacizumab treatment group compared to the control group. A positive correlation was found between tumour volume and MVD. CONCLUSION: Bevacizumab suppressed MFH tumour growth by inhibiting tumoural angiogenesis. The current study suggests that bevacizumab may be a novel therapeutic agent for MFH.

Magnetic resonance imaging of medullary bone infarction in the early stage.

Medullary bone infarctions, which are believed to arise due to arterial obstructions in the bone, are usually asymptomatic and are noted incidentally in roentgenograms or bone scans performed for other reasons. We present two cases of acute bone infarctions that were found accidentally by magnetic resonance imaging (MRI). In both cases, conventional radiographs could not demonstrate any findings and the cases were clinically asymptomatic. The current two cases suggest that MRI shows various findings in bone infarctions.