Fractures of the Patella in Children and Adolescents

Maguire, James K.; Canale, S. Terry

doi:10.1097/01241398-199309000-00002

Cited by 34 publications

(9 citation statements)

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“…The examination may reveal decreased flexion, inability to extend (or an extensor lag) and a large effusion. It is of note that the knee may be capable of active extension if there is an intact posterior cartilaginous hinge in continuity [3, 5, 6]. Often the knee is very tender and swollen, just like our case; thus palpation of a high-riding patella may be all that is ascertained.…”

Section: Discussionmentioning

confidence: 82%

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Bilateral Sleeve Fracture of the Inferior Poles of the Patella in a Healthy Child: Case Report and Review of the Literature

Guy

Marciniak

Tulwa

et al. 2011

Advances in Orthopedics

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The initial diagnosis of a sleeve fracture of the patella is key to a successful outcome with poor results well documented in the literature from delayed management. Diagnosis is difficult due to the rarity of this injury and thus the low likelihood the admitting junior doctor would think of this injury in their differential. They are very uncommon in incidence and have features on plain radiography that are difficult to interpret unless the surgeon is familiar with the anatomy of the immature patella. Missing the diagnosis can be disastrous for the patient. In this paper we describe the presentation of bilateral sleeve fractures in a healthy child, our initial investigations and subsequent management. We chose to repair with 5 Ethibond via 3 transosseous tunnels, initially reinforced with a circlage wire. On last review the boy maintains stable, pain-free knees with a full range of motion. The authors hope that this case and literature review will provide a valuable teaching aid and so assist in early, accurate diagnosis and cover the management options to achieve a positive outcome.

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Section: Discussionmentioning

confidence: 82%

“…The literature demonstrates numerous problems due to delayed or misdiagnosis [2, 6–8]. Eliciting a salient history focusing on the mechanism of injury is important.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Sleeve Fracture of the Inferior Poles of the Patella in a Healthy Child: Case Report and Review of the Literature

Guy

Marciniak

Tulwa

et al. 2011

Advances in Orthopedics

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“…Some authors recommend non-operative treatment for undisplaced fractures, but malalignment [9] and heterotopic ossification [4] have been reported. Maguire and Canale [12] advised partial or total patellectomy for displaced, comminuted patellar fractures in children without ipsilateral tibial or femoral fractures. The retinaculum, if torn, should be repaired after fracture fixation, and the articular surface should be realigned.…”

Section: Discussionmentioning

confidence: 99%

“…The treatment protocol for children is the same as that for adults [13]. Restoration of the extensor mechanism and realignment of the articular surface are essential [12,17]. Some authors recommend non-operative treatment for undisplaced fractures, but malalignment [9] and heterotopic ossification [4] have been reported.…”

Section: Discussionmentioning

confidence: 99%

Fractures of the patella in children

Dai

Zhang

1999

Knee Surgery, Sports Traumatology, Arthroscopy

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Fractures of the patella are relatively rare injuries for children. Fourteen patients with patellar fractures were reviewed. There were 12 boys and two girls with the age ranging between 9 and 15 years and an average of 11.4 years. Sleeve fractures were the most common type of patellar fractures observed (eight cases), followed by transverse fractures (four cases) and comminuted fractures (two cases). All the fractures were treated with open reduction and followed up for 2 to 20 years. Overall results were good in 13 patients, and flexion limitation of the knee was seen in one. Fractures of the patella in children are characterised by sleeve fractures. The prognosis of the patients treated with open reduction is generally good.

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“…Fractures involving the knee extensor mechanism, fracture of the patella and avulsion of the tibial tubercle, are rare injuries in paediatrics 1 2. When they occur they usually do owing to an acute incident of forced knee flexion in exercise such as a mistimed jump.…”

Section: Introductionmentioning

confidence: 99%

Knee extensor disruption in mild diplegic cerebral palsy: a risk for adolescent athletes

et al. 2013

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We report three cases of adolescent boys with mild diplegic cerebral palsy (CP) who suffered disruption of the knee extensor mechanism. Two had fractures of the patella and the third a fracture avulsion of the tibial tubercle combined with an undisplaced fracture of the patella. All three had gait analysis prior to sustaining the fractures and were known to have mild knee crouch. Each participated in sport including football. Each suffered an acute deterioration in gait resulting in a referral for repeat gait analysis, and x-ray of the affected knee. With the increased involvement of children with CP in sporting activities, especially children with mild knee crouch, we caution that knee extensor rupture might be an increasing problem.

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Fractures of the Patella in Children and Adolescents

Cited by 34 publications

References 0 publications

Bilateral Sleeve Fracture of the Inferior Poles of the Patella in a Healthy Child: Case Report and Review of the Literature

Bilateral Sleeve Fracture of the Inferior Poles of the Patella in a Healthy Child: Case Report and Review of the Literature

Fractures of the patella in children

Knee extensor disruption in mild diplegic cerebral palsy: a risk for adolescent athletes

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