Aims: To study clinical outcome of patients treated with a new design of the patellar tendon-tibial tubercle graft, which has reliable stability for transfer in recurrent dislocation of patella. Methods: 22 dislocations in 19 patients (3 bilateral) operated by this new technique were reviewed. There were 14 female and 5 male patients. Indications for surgery included functional disability due to repeated dislocations and failure of conservative management. Average age of the patient: 26 years (15–39 years). Duration of follow-up: 12–88months. Demographic data was collected by reviewing the case notes. Postoperative evaluation based on subjective pain evaluation score and Lysholm knee score. Surgical approach: limited infrapatellar midline incision, no internal fixation in any of the cases. Results: 75% of the patients had excellent to good result. There was no recurrence of instability/dislocation in any of the cases. Fair & poor (25%) results were graded based on stiffness and pain Conclusions: Multiple surgical procedures have been described for the management of recurrent dislocation of patella ranging from soft tissue realignment to bony procedures with internal fixation. Our results showed good functional improvement in the majority of the patients. This procedure is less extensive compared to the original procedure. Also there is the added advantage of no internal fixation and hence a second surgery for the removal of the implant can be avoided.

We report overuse injuries in 14 elbows of ten elite young gymnasts. In 12 elbows of eight patients aged 11 to 15 years there was a spectrum of radiological abnormalities including widening of the olecranon physis and fragmentation of the epiphysis. The radiographs were compared with those of normal elbows matched for age and sex. The radiograph appearances were very similar to those of the Osgood-Schlatter lesion of the tibial tuberosity. Two older boys, aged 18 and 19, had stress fractures through the olecranon growth plate. Conservative management was successful in all except one case of stress fracture which required internal fixation.

We report 21 cases of stress injury of the distal radial growth plate-occurring in gymnasts before skeletal maturity. The injury appears to be caused by inability of the growth plate to withstand rotational and compressive forces. Our observations have confirmed that the skeletal age of gymnasts is retarded, which increases the length of time during which the epiphysis is at risk of damage.