• Journal of Trauma and Injury
• /
• v.26 no.3
• /
• pp.218-221
• /
• 2013

A patella sleeve fracture is a type of avulsion fracture in which a small osseous fragment gets, along with a sleeve of periosteum and cartilage, is pulled off from the patella. The avulsed sleeve of cartilage and periosteum is not apparent on plain radiographs, which can result in a missed diagnosis or an underestimate of the extent of injury. An avulsion or sleeve fracture of the patella in a child can occur at the superior or the inferior pole of the patella. However, most reported cases of sleeve fractures involve the inferior patellar pole, with fractures involving the superior patellar pole being very rare. The authors report a case of a sleeve fracture of the superior pole of the patella in an adolescent; the fracture was diagnosed with magnetic resonance imaging (MRI) and was treated with surgery after early diagnosis. The course was uneventful, and the outcome was excellent.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.10 no.2
• /
• pp.109-112
• /
• 2011

Anatomical reduction and strong fixation in displaced patella fracture are needed for restoration of knee function and strength and early range of motion exercise. According to the type of fracture and various operational methods, their many complications have been reported. We report 2 cases of transverse patella fracture which were caused by transverse screw fixation in longitudinal patella fracture and fracture of bipartite patella in athletes.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.8 no.2
• /
• pp.121-124
• /
• 2009

Patellar fractures in children represent less than 2% of all patellar fractures including adults, and occur about 1% of all pediatric fractures. Because of property of the growing patella, osteochondral or avulsion fractures are more common in children and the most common type of patella fracture in children is sleeve fracture. Avulsion or sleeve fractures of the patella in children can occur at the superior or inferior pole of the patella. Most reported cases of sleeve fracture are involving the inferior patellar pole, but involving the superior patellar pole is very rare. We experienced a case of sleeve fracture occurred at the superior pole of the patella in a sixteen-year-old boy and report this case with literature review.

• Journal of Trauma and Injury
• /
• v.34 no.4
• /
• pp.305-308
• /
• 2021

Comminuted fractures of the patella mostly occur at the inferior pole and require appropriate reduction and fixation to restore the extensor mechanism. Conventional methods such as tension-band wiring are not enough to gain proper fixation strength. Numerous methods have been reported, including circumferential cerclage wiring, osteosynthesis, and suture anchors depending on the fracture pattern. Herein, the author reports a relatively rare case of a comminuted fracture of the upper pole of the patella, for which we used augmented Krackow sutures in the quadriceps and fixation with tying of the suture limbs through patellar bone tunnels. Satisfactory results were obtained in terms of reduction and extensor mechanism recovery.

• Journal of the Korean Orthopaedic Association
• /
• v.56 no.6
• /
• pp.540-545
• /
• 2021

A transverse fracture is the most common type of displaced patella fracture requiring surgery. These fractures are commonly fixed with parallel Kirschner wires or screws that cross the fracture line, often with an additional tension band. Nevertheless, conventional fixation methods of patella fractures have prevalent complications caused by the protrusion of wires or pins. These complications necessitate additional surgery for hardware removal, increase medical cost, and can limit the function of the knee joint. This paper reports cases treated with a minimally invasive load-sharing percutaneous suture of the patella tendon. The procedure provides reliable fixation for transverse patella fractures, minimizes soft tissue injuries, preserves blood flow, and reduces postoperative pain. In addition, the procedure also reduces the irritation and pain caused by the internal fixture, thereby reducing the risk of restricted knee joint movement.

• The Journal of Korean Orthopaedic Ultrasound Society
• /
• v.3 no.1
• /
• pp.26-31
• /
• 2010

Purpose: The purpose of this study is to evaluate the clinical usefulness of ultrasound in treatment of patella fracture. Material and Methods: Twenty cases of twenty patients with patella fracture radiographically from March, 2006 to September, 2009 were involved in this study, there were 8 males and 12 females, there were 13 right knees, 7 left knees, the average age was 43 years (range, 14~72 years). We decided the methods of treatment by using the ultrasound in conjunction with Drayer's test that examining the intactness of patella retinaculum. There were 10 transverse, 8 vertical and 2 comminuted fractures, we examined the patella retinaculum by using the ultrasound and performed Drayer's test. Results: In 12 cases of intact retinaculum, Drayer's test was negative and we allowed patients ambulation without surgical fixation especially. In 4 cases of completely ruptured retinaculum, Drayer's test was positive and we treated the patella fractures by the use of ORIF (open reduction and internal fixation) method, in 2 cases of partially ruptured retinaculum, Drayer's test was negative but displacement of fractures were more than 2 mm, we treated the patella fractures by the use of CRIF (closed reduction and internal fixation) method and obtained clinically satisfactory results. Conclusion: In conjunction with radiographs and Drayer's test, an ultrasound would be one of the useful diagnostic modality for determining treatment method of the patella fracture.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.28 no.3
• /
• pp.89-99
• /
• 2022

Background: The purpose of this study was to investigate the effects of physical therapy intervention with local vibration on the physical function of patients with traumatic patella fractures. Methods: This study recruited 6 subjects who had suffered traumatic patella fractures. The study was conducted for an average of 12.8 weeks. Before the treatment (2 weeks post-surgery), they were evaluated using the numeric pain rating scale (NPRS), the Korean-version of the impact of event scale-revised (IES-R-K), pressure pain threshold (PPT), range of motion (ROM) of the knee joint, and the Korean knee injury and osteoarthritis outcome score (K-KOOS) and were reevaluated after 7 and 12 weeks, post-surgery. This study was conducted according to ORIF Patella Fracture Post-Operative Rehabilitation Protocol after applying local vibration. The protocol consists of Phases 1~5 and this study has been applied from phase 2. Results: A comparison of the performance of the participants before and after the intervention showed a decrease in NPRS (9.83±.41→4.83±.98), IES-R-K (68.67±2.73→23.83±2.40), and K-KOOS (Function, Daily living: 70.5±5.96→34.0±3.35, Function, Sports and Recreational activities: 22.83±2.32→10.77±1.37, Quality of Life: 19.33±7.33→7.33±.52) scores. And the ROM (Knee flexion: 30.0±4.47°→128.73±3.6°, Knee extension: -6.83±2.48°→-1.33±1.03°) and PPT (9.67±.52kg/cm²→22.44±2.33kg/cm²) scores increased. Conclusion: These results show that physical intervention with local vibration using a Blackroll® booster and head can help to improve pain, physical function, and psychological status. Also, it was possible to select interventions depending on the patient's condition and the desired goal, using physical intervention with the Blackroll® booster technique.

• Journal of the Korean Arthroscopy Society
• /
• v.5 no.2
• /
• pp.104-110
• /
• 2001

Purpose : To analyze the patterns of osteochondral fracture associated with patellar dislocation and to assess the results of arthroscopic treatment. Materials and Methods : Fourteen patients were treated from March, 1989 to April, 1998 for patellar dislocations with osteochondral fracture. The average follow-up was 32 months. All were treated by arthroscopic procedures. The location and size of the fracture fragments were recorded. To assess the functional results, we used Larsen & Lauridson's score system. Results : Osteochondral fractures were found 8 cases in medial side of patella, 1 case in lateral side of patella, 5 cases in lateral margin of lateral femoral condyle. The range of maximal diameter of osteochondral fragment was from 1cm to 4.2cm. Treatments include fragment excision only in 6 cases, excision and medial retinacular repair in 2 cases, excision and medial retinacular repair and lateral retinacular release in 3 cases, and internal fixation only in 3 cases. The functional results were excellent in 5 cases$(36\%)$. good in 6 cases$(43\%)$, fair in 1 case$(7\%)$ and poor in 2 cases$(14\%)$. Conclusion : In osteochondral fractures associated with patellar dislocation, arthroscopic treatment is useful to diagnose precisely, to determine proper treatment modality, and to minimize the complications.

• Journal of the Korean Arthroscopy Society
• /
• v.14 no.2
• /
• pp.131-134
• /
• 2010

Inappropriate treatment of osteochondral fracture can cause osteoarthritis, pain, functional disorder. With large osteochondral fracture, reduction and fixation of the fragment using metal implant. However, when the bone fragment had less than 2mm, the fragment extracted because of difficulty of fragment fixation. Authors treated patients with fracture fragment thickness less than 2mm of osteochondral dissecans in medial femoral condyle and patella fracture using biodegradable meniscus screw, and then we obtained good result.

• Journal of Korean Medicine Rehabilitation
• /
• v.30 no.4
• /
• pp.203-217
• /
• 2020

The aim of this study was to propose our rehabilitation protocol involving Korean medicine for patients with patellar fracture and report its effectiveness. Further, for the same patellar fracture patients, we created different protocols for those who underwent surgical treatment and those who required conservative treatment. Among patients who received inpatient treatment at our hospital for three years from August 2017 to August 2020, we included three patients who underwent surgical treatment for patellar fracture and one patient who required conservative treatment for patellar fracture. The degree of improvement of the patients was evaluated using physical examination findings of the knee joint, numeric rating scale, pain disability index, Lysholm knee score, and walking state. After each treatments, we observed that the range of motion of the knee joint, numeric rating scale, pain disability index, Lysholm knee score, and walking state improved in the patient groups. Even with the same patellar fracture, we observed that different rehabilitation treatments involving Korean medicine should be applied to patients who underwent surgical treatment and those who required conservative treatment. However, further studies are needed to design a rehabilitation protocol involving Korean medicine.