Faculty Collaboration Database

Patellar Sleeve Fracture With Ossification of the Patellar Tendon. Orthopedics 2017 Mar 01;40(2):e357-e359

Date

11/01/2016

Pubmed ID

27798714

DOI

10.3928/01477447-20161026-02

Scopus ID

2-s2.0-85016436888 (requires institutional sign-in at Scopus site)   11 Citations

Abstract

Patellar sleeve fractures make up greater than 50% of all patellar fractures. They are essentially only seen in the pediatric population because of the thick periosteum and the distal patellar pole apophysis in this group. These fractures can lead to complications if not treated appropriately and in a timely fashion. Complications of missed or untreated patellar sleeve fractures include patella alta, anterior knee pain, and quadriceps atrophy. These can all result in severe limitations in activity. The authors describe a case of a 16-year-old boy who sustained a patellar sleeve fracture 3 years prior to presentation. On presentation, he had patella alta, diminished strength, 5° of extensor lag, and radiographs that revealed bone formation along the patellar tendon. Despite this, he was able to maintain a high level of activity. This case report explores how the patient could have maintained a high level of activity despite having a patellar sleeve fracture. Also, because of the delayed presentation, the patella was ossified and the quadriceps was retracted, which led to a novel approach to reconstructing his distal extensor mechanism. This approach included a V-Y advancement of the quadriceps tendon and patellar tendon reconstruction using the patient's hamstring tendon (semitendinosus). This technique, combined with physical therapy postoperatively, resulted in his return to varsity high school soccer. To the best of the authors' knowledge, this technique has not been reported for this rare condition. [Orthopedics. 2017; 40(2):e357-e359.].

Author List

Damrow DS, Van Valin SE

Author

Scott Van Valin MD Associate Professor in the Orthopaedic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Delayed Diagnosis
Fractures, Bone
Humans
Male
Orthopedic Procedures
Ossification, Heterotopic
Patella
Patellar Ligament
Soccer