Sleeve-like avulsion fracture of the superior pole of the patella in a healthy adult

Teixeira, Pedro Augusto Gondim; Lecocq, S.; Moisei, A.; Chanson, Anne; Louis, Marlon Jones; Blum, Alain

doi:10.1016/j.diii.2012.09.002

Cited by 6 publications

(10 citation statements)

References 13 publications

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“…Conservative management is usually indicated in minimally of patella among the healthy adults. The clinical data of the previously reported cases are summarized in Table 1 [2,3,5,6,7].…”

Section: Discussionmentioning

confidence: 99%

“…As far as English literature is concerned, we are reporting the 6th case of the SF of the patella in adults and probably the 1st neglected case of the superior pole of patella among the healthy adults. The clinical data of the previously reported cases are summarized in Table 1 [ 2 , 3 , 5 , 6 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…It is proposed that SF of the inferior pole is due to a rapid contraction of the quadriceps muscle as occurs in jumping and skateboarding. In contrast, superior pole fracture occurs as a result of rapid quadriceps muscle contraction with knee flexion at the time of injury resulting in more force transmitted to the upper pole as compared to the inferior pole [ 5 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

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Neglected Isolated Sleeve Fracture of the Superior Pole of the Patella in a Healthy Adult – A Case Report and Review of Literature

Kushwaha¹,

Kumar²,

Bharti³

et al. 2021

JOCR

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Introduction: Sleeve fracture (SF) represents an unusual type of patellar fracture and has been reported mainly in children or adolescents. Superior pole fracture in adults is a very rare occurrence because the enthesis of the adult patella is more resilient to avulsion injury as compared to an immature pediatric skeleton. Due to the rarity of these fractures in adults and vague radiographic findings, the chances of missing the fracture are very high. Case Report: An 18-year-old boy presented to our outpatient department with a history of fall while trying to jump across a wall 6 months ago. At the time of presentation, the patient mainly complained of loss of active extension of the knee in the sitting position and a palpable gap over the upper part of the patella. After radiographic evaluation, a diagnosis of SF was made. The patient was managed surgically, and thereafter, early rehabilitation was done. After 10 weeks post-surgery, the patient was free from any pain, had a full range of motion, and was able to walk without support. Conclusion: Adults presenting with acute injury to knee with limitation of extension and palpable gap over the superior pole of the patella, a differential diagnosis of SF must be suspected and should be ruled out by clinical examination and relevant investigations. Keywords: Sleeve fracture, patella, superior pole, adult.

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“…Conservative management is usually indicated in minimally of patella among the healthy adults. The clinical data of the previously reported cases are summarized in Table 1 [2,3,5,6,7].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Neglected Isolated Sleeve Fracture of the Superior Pole of the Patella in a Healthy Adult – A Case Report and Review of Literature

Kushwaha¹,

Kumar²,

Bharti³

et al. 2021

JOCR

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“…Except for such weakened skeleton, only 2 cases of sleeve fractures in healthy adult men have been reported in the English literatures. [ 3 , 4 ] The current case is of interest because of such a rare form of injury occurred in healthy adult woman that has not yet been reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

Sleeve fracture of the adult patella

et al. 2017

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Rationale:The patellar fractures are common in adults, but rare in children. As a particular type of patellar fracture, however, sleeve fractures are almost always limited to children in the under 16's group.Patient concerns:Herein, we report a rare case of a 19-year-old healthy adult female who presented sleeve fracture at the superior pole of the left patella. The clinical and radiological features are found including joint effusion, anterior tilt of the patella and a shell of bone lying proximally to the patella.Diagnoses:Computed tomography and magnetic resonance imaging examination have been performed to further confirm the diagnosis of sleeve fracture, rupture of the quadriceps tendon and the cartilaginous injury.Interventions:Under general anaesthesia, she underwent open surgical procedures for reconstituting anatomically the fracture and repairing the rupture of the quadriceps tendon.Outcomes:Six months after the operation, she could fully use her left knee without any pain and disability.Lessons:Sleeve fractures of the patellar in adults are extremely rare, and our case is of interest for the first time occurring in healthy female adults. Our case report and literature review was aim to describe the clinic and imaging characteristics of superior pole sleeve fractures in adults, and highlight that physicians must be aware of this entity in adults so as to reduce misdiagnosis due to unfamiliarity.

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“…As per the available English literature only four cases have been reported in other age groups till date. Out of which three were males and one female [ 3 , 4 , 5 ]. We present sleeve avulsion of patella for the 1st time in 23 years age group.…”

Section: Introductionmentioning

confidence: 99%

Case Report on Sleeve Avulsion of Patella in Young Adult

Quraishi¹,

Khan²,

Quraishi³

2021

JOCR

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Introduction: Sleeve avulsion of patella is extremely rare, limited almost to children. However, few cases have been reported in adults. Rarity of this fracture makes the diagnosis and choice of treatment difficult. Inability to raise leg remains important clinical sign for quadriceps mechanism insufficiency. In the absence of standard treatment guidelines pullout sutures through patella provides a secure and stable fixation option. Our case remains the first to be reported ever in English literature in a 23-year-old male with a superior pole avulsion patella being treated with Krakow pullout suture. Case Report: A 23-year-old Indian male was admitted with left knee pain and swelling following fall from bike. He had knee pain, swelling, and inability to bear weight. Active straight leg raising was not possible. On X-ray he had small bony sleeve visible near proximal pole of patella. Magnetic resonance imaging (MRI) was done which showed sleeve avulsion of patella at proximal pole. Under spinal anesthesia fracture was exposed through midline approach. Pullout Krakow sutures were taken through quadriceps tendon and fracture fragments using 3 no Polyester suture. Transosseous tunnels were drilled in patella and tied distally. At 4 months patient had no extension lag with full range of movements. At 14 months follow-up patient is asymptomatic and able to run, squat, sit cross legged, and do his day-to-day activities. Conclusion: Sleeve avulsion of patella in adults is extremely rare with only few cases reported in literature. MRI is not only useful for diagnosis but also for deciding treatment modality. Krackow technique with Polyester suture through quadriceps tendon incorporating fracture fragment passed through patellar transosseous tunnel provides secure fixation with excellent results. Also avoids any future hardware problems in this subcutaneous bone. Keywords: Sleeve avulsion, Krakow suture, pull out technique.

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Sleeve-like avulsion fracture of the superior pole of the patella in a healthy adult

Cited by 6 publications

References 13 publications

Neglected Isolated Sleeve Fracture of the Superior Pole of the Patella in a Healthy Adult – A Case Report and Review of Literature

Neglected Isolated Sleeve Fracture of the Superior Pole of the Patella in a Healthy Adult – A Case Report and Review of Literature

Sleeve fracture of the adult patella

Case Report on Sleeve Avulsion of Patella in Young Adult

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