[Experiences with the Sarmiento-cast]

The patella-tendon-bearing cast described by Sarmiento was used in the treatment of 96 tibial fractures. Full weight-bearing was permitted even if the fractures were completely unstable and had a marked tendency to shorten. Only in one case weight-bearing led to a dislocation of the fragments. Specific complications were not seen. It was evident that the PTB-cast was most advantageous to the patient in comparison with a conventional cast and sometimes even in comparison with an osteosynthesis, which does not tolerate weight-bearing. To integrate the Sarmiento-cast in the routine of a small or middle sized hospital, we recommend to observe the following rules: 1. The cast is not applied immediately after the accident, but after one to three weeks of conventional conservative treatment. 2. It is made by two specially trained doctors. 3. The controls of the out-patients are performed in the hospital and not delegated to the family doctor.