• 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.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 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 Korean Orthopaedic Sports Medicine
• /
• v.7 no.2
• /
• pp.128-134
• /
• 2008

Purpose: We prospectively evaluated the clinical usefulness of the patellar inferior pole (PIP) as a landmark of the anteromedial (AM) portal for the arthroscopic surgery of the medial mensiscus posterior horn (MMPH). Materials and Methods: Group 1 (50 normal left knees of adults), Group 2 (10 normal knees under anesthesia), and Group 3 (50 consecutive knees undergoing elective arthroscopic surgery for relatively simple intraarticular pathologies, or diagnostic arthroscopy) were included. In Group 1 and 2, the true lateral (A) and valgus stress lateral radiographs (B) on $30^{\circ}$ flexion were obtained, and the lines (AM portal line) passing through the PIP and distal-most medial femoral condyle (MFC) were drawn under the condition without considering the thickness of articular cartilage of MFC (1, 2-A, B group), and considering it as 2.5mm on B (1, 2-C group). Then, we investigated the meeting point of the AM portal line with medial tibial plateau (C-D percentage), and measured the distance between the PIP and the anterior joint line (E-length), and medial tibial-femoral joint space (F-length). In Group 3, the AM portal was made at the PIP level and clinical usefulness of the approach to the MMPH and body of the lateral meniscus (LM) was analyzed. Results: The average C-D percentage came out as 85.8, 101.3, 69.1% for each Group 1-A, B, C, and 102.4, 144.6, 116.8% for each Group 2-A, B, C. Measured E-length was an average of 15.1 (Group 1-A), 15.5 (Group 1-B, C), 13.1 (Group 2-A), and 12.9 mm (Group 2-B, C) and the change by valgus stress had no statistical significance. The F-length increased about 1.2 (Group 1) and 3.6 mm (Group 2) when valgus stress was applied, which had statistical significance (p<0.001, p<0.001). In Group 3, 49, 48 knees were classified as good for the MMPH, and the body of LM in aspect of the clinical usefulness of AM portal made on the PIP level. Conclusion: We identified the clinical usefulness of the PIP as a skin landmark of AM portal for the arthroscopic surgery of the MMPH.