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Surgical treatment of patellar sleeve fractures in children

Publication at Faculty of Medicine in Hradec Králové |
2021

Abstract

The patellar fractures do not occur very often in children. Conservative therapy is usually indicated.

A specific type of patella fracture in children is the sleeve fracture of the lower pole of the patella. Diagnosis can be difficult.

In case of clinical and X-ray suspicion, it is possible to use ultrasonographic examination or magnetic resonance imaging can be used for clinical uncertainty. Inadequate treatment of a displaced sleeve fracture of the patella leads primarily to impaired knee function.

Three patients, who underwent surgical treatment of patellar fracture sleeve in childhood, were documented. The first of them was misdiagnosed preoperatively, when a small fragment was considered an avulsion of tuberosity of the tibiae.

In this case, small fragments were removed during an open surgical revision and the patellar ligament was reinserted to the patella using Krackow stitch. In the other two patients, a typical clinical and X-ray finding was obvious for a sleeve fracture of the lower pole of the patella.

In both cases, open reduction and osteosynthesis were performed using cannulated screws. One patient developer postoperative calcifications in the patella ligament after osteosynthesis.

However, all patients fully participated in normal life, including sports activities, after the end of treatment.