Bifocal avulsion fracture and fixation of the patellar tendon: a case report

Atzmon, Ran; Iohanes, Eitan; Dubin, Jeremy A.; Rosenthal, Alex; Drexler, Michael; Sherman, Seth L.

doi:10.1016/j.jisako.2023.07.001

Cited by 1 publication

(2 citation statements)

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“…Trifocal injuries involving the avulsion of the patellar tendon and occurring in the absence of definitive radiographic signs are quite rare [ 2 ]. Typically, in young patients, injuries affecting the inferior pole of the patella and tuberosity are of the avulsion type.…”

Section: Discussionmentioning

confidence: 99%

“…The suggested mechanisms of injury, including a direct impact on the distal patella with forceful flexion of the lower leg, a central blow to the patellar tendon with divergent forces against the bony insertions, or a quadriceps overload leading to eccentric muscle contraction during knee flexion, provide valuable insights into potential causes [ 2 ]. Repeated trauma immediately one after the other can also be considered now.…”

Section: Introductionmentioning

confidence: 99%

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Trifocal Injury of the Patellar Tendon- An Exceedingly Rare Case Report

Deore,

Kale,

Chalak

et al. 2024

jocr

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Introduction: Distal pole of patella avulsion fracture with tibial tuberosity avulsion has been frequently reported as a bifocal patellar tendon injury. However, an osteochondral lateral patella facet fracture with a longitudinal split in the patella tendon in addition to these avulsion fractures has never been documented previously. Hence, we now report this trifocal patellar tendon injury. Case Report: An adolescent with a trifocal patella tendon injury underwent a fixation with a combination of transosseous pull- through sutures, suture tape, and knotless anchor. The patient was rehabilitated with gradual increase in 30° of knee flexion weekly and has now attained full knee range of motion. Conclusion: Fixation of the small avulsion fracture can be challenging using conventional methods such as cannulated cancellous screws especially in an immature skeleton as it can crush the fragments. Suture tape, transosseous tunnels, and knotless suture anchors have more flexibility, they avoid the physis and provide adequate strength in such situations compared to metallic implants. Keywords: Inferior pole of patella avulsion, tibial tuberosity fracture, knotless suture anchor, suture tape.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%