ABSTRACT
Objective:To analyze the clinical characteristic of patellar sleeve fracture in children, so as to improve the understanding of pediatric patellar sleeve fracture and reduce the misdiagnosis rate.Methods:Clinical data of 18 children with patellar sleeve fractures admitted and followed up in Department of Pediatric Orthopedic Surgery, Affiliated Hospital of Zunyi Medical University from January 2013 to December 2019 were retrospectively analyzed, including 10 males and 8 females with the mean age of 11.4 years (8.0-14.0 years). There were 10 right patellar sleeve fracture cases, 7 left cases, and 1 case on both sides.Classified by the fracture cause, 10 cases were caused by falls, 3 cases of high jump, 2 cases of falling from height, 2 cases of car accidents, and 1 case of rope skipping, and all of cases were closed injuries.The mean post-injury visit to Affiliated Hospital of Zunyi Medical University was 3.5 days (4 hours -7 days). Twelve out of cases were transferred from other hospitals.All patients were treated with the open reduction and tension band wiring or patella tendon suturing through bone tunnel + patella circumferential wire banding and fixation.The curative effect of patella fracture was evaluated by the Bostman score.Results:Eighteen children with patellar sleeve fracture were diagnosed and treated promptly after admission, and regularly followed up after the operation for an average of 14 months (9-28 months). All cases achieved stage Ⅰ wound healing, and Kirschner wires and steel wires were removed according to the condition of fracture healing at 6 to 10 months postoperatively.According to the Bostman score for evaluating the patella fracture, 15 cases were excellent, 3 cases were good, and there were no missed or misdiagnosed cases.Conclusions:Patella sleeve avulsion fracture is a unique type of fracture in children.As cartilage is the main distal avulsion fracture lesion, it is difficult to be detected on X-ray scans, thus easily leading to missed diagnosis and misdiagnosis.Improving the understanding of this fracture type is the key to the early diagnosis and treatment.
ABSTRACT
Sleeve fracture at the inferior pole of the patella in children is relatively common, yet it is rare for the superior pole to be affected. So, only a few such cases have currently been reported. We experienced a 15 years-old patient with a sleeve fracture at the superior pole of the patella secondary to disuse osteopenia after cast immobilization due to knee trauma. We report on this case and we review the relevant literature.
Subject(s)
Child , Humans , Bone Diseases, Metabolic , Immobilization , Knee , PatellaABSTRACT
Sleeve fractures of the patella are cartilaginous avulsion fractures from the lower pole of the patella. They occur mainly due to sports injuries in adolescents. They may be missed in diagnosis due to rare incidence and small bony fragment on simple radiographs. In this report, an unusual bilateral simultaneous sleeve fracture in a healthy child is described.
Subject(s)
Adolescent , Child , Humans , Athletic Injuries , Diagnosis , Incidence , PatellaABSTRACT
Objective To study the effects of the early diagnosis and treatment of sleeve fractu re of patella in children.Methods The retrospection study was done to a nalyse the effects of the diagnosis a nd treatment of ten samples of sleeve fr acture of patella in our hospital fro m 1993to 2001.Results The diagnosis was confirmed by the characteristic s of the tension swelling of the knee,high position of the patella and a sle eve fractured fragment in the patella.T he operations were the main initial t reatment to regain the proper reduction.After 4weeksfixation the patients did knee exerc ises.And the curative effects were q uite good.Conclusion The sleeve fracture of the patella in children is easy to be misdiagnosed o r missed because of the cartilage.So it is the more important to be able to con duct an early diagnosis and treatmen t for the better prognosis.
ABSTRACT
Sleeve type fracture of the patella in children is an extremely rare injury. Its avulsed fragment is so small that the diagnosis may be missed by radiogram and patella slta is complicated. A 14 year-old boy having the sleeve type fracture of the patella with patella alta was treated by open reduction with s screw fixation at St. Vincent Hospital in December 1985 and was followed up over two years. The final clinical result was good.