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Case Reports
. 2017 Aug;96(32):e7096.
doi: 10.1097/MD.0000000000007096.

Sleeve fracture of the adult patella: Case report and review of the literature

Linjun Xie  1 , Hong Xu, Lizhi Zhang, Rong Xu, Yingkun Guo
Affiliations
Case Reports

Sleeve fracture of the adult patella: Case report and review of the literature

Linjun Xie et al. Medicine (Baltimore). 2017 Aug.

Abstract

Rationale: The patellar fractures are common in adults, but rare in children. As a particular type of patellar fracture, however, sleeve fractures are almost always limited to children in the under 16's group.

Patient concerns: Herein, we report a rare case of a 19-year-old healthy adult female who presented sleeve fracture at the superior pole of the left patella. The clinical and radiological features are found including joint effusion, anterior tilt of the patella and a shell of bone lying proximally to the patella.

Diagnoses: Computed tomography and magnetic resonance imaging examination have been performed to further confirm the diagnosis of sleeve fracture, rupture of the quadriceps tendon and the cartilaginous injury.

Interventions: Under general anaesthesia, she underwent open surgical procedures for reconstituting anatomically the fracture and repairing the rupture of the quadriceps tendon.

Outcomes: Six months after the operation, she could fully use her left knee without any pain and disability.

Lessons: Sleeve fractures of the patellar in adults are extremely rare, and our case is of interest for the first time occurring in healthy female adults. Our case report and literature review was aim to describe the clinic and imaging characteristics of superior pole sleeve fractures in adults, and highlight that physicians must be aware of this entity in adults so as to reduce misdiagnosis due to unfamiliarity.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
A 19-year-old female with sleeve fracture at the superior pole of the left patella. Patella and avulsed fragment are showed in plain radiograph (arrows).
Figure 2
Figure 2
On computed tomography (CT) images, a shell of bone lying proximally to the patella is showed on multiplanar reconstruction (A) and shaded surface display images (B).
Figure 3
Figure 3
Quadriceps tendon rupture, cartilaginous injury (arrowheads), and joint effusion are visualized at 1.5 T magnetic resonance image (saggital view, FSE sequence, TR 3,700 ms, TE 46 ms).
See this image and copyright information in PMC

References

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    1. Ro KH, Park JH, Kim MJ, et al. Rare sleeve fracture of the superior patella pole in an adult due to forceful passive physiotherapy following cast immobilization. Knee 2014;21:600–4. - PubMed
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