Inferior Pole Sleeve Fracture of the Patella in an Adolescent: A Case Report

Abstract

An 11-year-old boy was admitted to our hospital due to severe pain in his right knee when he landed after jumping over a vaulting box. A plain X-ray image and computed tomography scan showed an avulsion fracture of the lower pole of the patella and patella alta. Furthermore, magnetic resonance imaging (MRI) revealed an articular cartilage lesion and rupture between the inferior pole of the patella and the patella tendon. We diagnosed a sleeve fracture of the patella and performed surgical treatment. Open reduction and internal fixation were performed by the pull-out technique using transosseous no. 2 MaxBraid™ (Zimmer Biomet, Tokyo, Japan) sutures. While postoperative weight-bearing was permitted, the knee joint was immobilized in a brace for four weeks. Three months of postoperative assessment revealed excellent functional outcomes.

Patellar Avulsion Fracture

“…Additional cerclage around the patella is recommended for comminuted fractures [14]. Other materials can be used, such as ultra-high-molecular-weight polyethylene (FiberWire), which has been shown to have better outcomes in certain types of fractures [15,16]. A recent randomized controlled trial discussed the use of headless screws in cadaver knees and showed comparable outcomes to cannulated screws for fixation strength and subfailure fragment displacement.…”