Missed Sleeve Fracture of the Superior Pole of Patella

Patella Sleeve Fracture with Medial Patellofemoral Ligament Tear and Lateral Femoral Condyle Fracture in an Adolescent

“…Twenty-six cases of patella sleeve fracture of the superior pole have been reported in the pediatric population 2,6-24 . The most recent literature review on this topic included 16 cases 23 .…”

“…Seventeen cases involved surgical fixation with various techniques, including tension band wiring, Krackow whip stitches, figure-of-eight technique, use of bone and suture anchors, and open reduction internal fixation of the patella with bone tunnels and suture repair 6-11,14,15,17-24 . Eight cases involved nonoperative management with 3 to 8 weeks of immobilization 2,6,13,16 in one patient with a fracture displacement of 2 mm 13 , one patient with a missed initial diagnosis 2 , and 5 patients with late presentations between 4 and 11 weeks 6 . One case failed to mention treatment 12 .…”

“…Cases with purely cartilaginous sleeves are undetectable radiographically. Several instances of delayed diagnosis have been presented 2,7,9,10,15,16 . MRI and ultrasound are both helpful for diagnosis and can be used to measure fracture displacement.…”

“…Patella sleeve fracture of the superior pole is rare. Twenty-six pediatric cases have been reported in the literature 2,6-24 , many of which describe isolated injury 2,6,7,9,15,16,20 . We present the first case to include associated medial patellofemoral (MPFL) tear and lateral femoral condyle (LFC) fracture in an adolescent.…”