Pediatric Patellar Avulsion Frx (Sleeve Fracture)
- See: Osteochondral Frx
- type of osteochondral frx of the patella which results from high impact jumping activities
- mechanism: eccentric contraction of the quadriceps on the flexed knee;
- occurs when the inferior pole of the patella of a child or adolescent is pulled off together with a large amount of articular cartilage and retinaculum;
- superior fragment (devoid of cartilage) is pulled superiorly;
- diff dx:
- Bipartite patella
- Sindig-Larsen-Johanssen disease
- local pain & tenderness
- extension lag (inability to fully extend the knee actively);
- small bone fragment will suggest the diagnosis, but it can be difficult to see on standard radiographs;
- high-riding patella in comparison with contralateral side;
- MRI: study of choice to confirm the dianosis;
- these injuries require surgical intervention w/ anatomical reduction and rigid internal fixation of the patellar frx and the sleeve of articular fracture;
- remember the distal fragment can be much larger than it appears on the radiographs because it consists largely of cartilage
Sleeve fractures of the patella in children: a report of three cases.
Sleeve fracture of the patella in children. A report of five cases.
Avulsion fractures of the patella.
Partial sleeve fractures of the tibia in children: an unusual fracture pattern.
Original Text by Clifford R. Wheeless, III, MD.
Last updated by Data Trace Staff on Wednesday, February 6, 2013 4:53 pm