Implant Free Repair of Pediatric Patella Sleeve Avulsion Fracture

Volume 6 | Issue 2 | May-Aug 2018 | Page 45-47 | Sathya Vignes, Santhosh Sahanand, David Rajan.

Authors: G Sathya Vignes [1], Santhosh Sahanand [1], David V Rajan [1].

[1] Department of Orthopaedics, Ortho One Orthopaedic Speciality Hospital, Coimbatore, Tamil Nadu, India.

Address of Correspondence
Dr. G. Sathya Vignes,

Sri Athi Sathya Hospital,

Perundurai Road, Erode.

Email: sathyavg88@gmail.com

Abstract

Introduction: Sleeve avulsion fractures of the patella are rare fractures that occur more commonly in children and adolescents. The diagnosis is difficult both clinically and radiologically since the distal bony fragment may be too small to be detectable by radiography. A high-riding patella and hemarthrosis are important signs of sleeve fractures.

Case Report: A 10-year-old boy was admitted to our ER after having felt a severe pain in his Right knee on kicking the ground while playing foot-ball two days earlier. Knee swelling, haemarthrosis and periarticular tenderness were noted. On physical examination, an extension lag of 15 was observed. The active range of motion of the injured knee was 45-60° of flexion. Radiography showed an avulsion fracture of the lower pole of the patella and a high-riding patella. We performed open reduction and internal fixation surgery with Transosseous Tunneling and Suture Pull Through using a multi-strand, long chain ultra-high molecular weight polyethylene (UHMWPE) wire. At 6 weeks after surgery, there was no extension lag, and the active range of motion of the injured knee was 0-140° of flexion. Callus formation over the fracture site and bone union was confirmed.

Conclusion: Although sleeve fractures in children are uncommon, it should be considered a possibility in children with complaints of pain around the knee postinjury. This technique of Implant Free ORIF was effective in the treatment of sleeve fracture of the patella and alleviates the need for a resurgery for implant removal.

Key words: Sleeve fracture patella, open reduction and implant free fixation.

References

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