Superior Patellar Sleeve Fracture after Serial Knee Injuries / 대한정형외과학회잡지

Sleeve fractures of the superior pole of the patella are rare but usually occurs in adolescents with an immature skeletal system. This paper reports a 15-year-old male who complained of knee pain after a bicycle accident. The initial radiographs and magnetic resonance imaging showed a bony bruise of the patella with signal change on the medial meniscus. After conservative treatment with immobilization for four weeks, he slipped down, and eccentric forced flexion of the knee was applied. This second injury caused a sleeve fracture of the superior pole of the patella. After splint immobilization for five weeks, the patient showed adequate function of the quadriceps and range of motion.Among the cases collected, some patients showed a similar history of sleeve fracture of the superior pole of the patella after serial knee injuries.

Operative Treatment of Medial Epicondyle Fractures in Pediatric and Adolescent Patients: Comparative Study of Internal Fixation with Kirschner Wires or Cannulated Screws / 대한스포츠의학회지

Purpose@#Medial epicondyle fractures are a common elbow injury in pediatric and adolescent patients. The management of these fractures continues to be debated. This study aims to review the long-term clinical and radiological outcomes of operative treatment of medial epicondyle fractures in pediatric and adolescent patients. @*Methods@#In this study, 24 consecutive patients were categorized into two groups as follows: group 1, 10 patients undergoing internal fixation with Kirschner wires (K-wires) and group 2, 14 patients undergoing internal fixation with cannulated screws. To assess clinical outcomes, Mayo Elbow Performance Score were used in addition visual analogue scale for pain, subjective range of motion, ulnar nerve irritation symptoms, residual instabilities and requirement for secondary surgery were checked. To access the radiological outcomes, check the bone union and possible deformities secondary to the medial epicondyle fractures were examined. @*Results@#There were no cases of immediate or residual ulnar nerve irritation symptoms and no cases of residual deformity or valgus instability. There was no radiological evidence of loss of reduction and all patients had achieved bone union at last follow-up. And all patients had performed secondary surgery for hardware removal regardless of symptomatic hardware irritation. @*Conclusion@#Both K-wires fixation for younger children and screw fixation for near skeletal maturity children may provide favorable clinical and radiological outcomes at long-term follow-up, with low morbidity and radiographic deformity. In the K-wire fixation group, it is thought that preoperative explanation is needed because the K-wires tends to be removed earlier than screw fixation group due to hardware irritation.