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Case Reports
. 2025 Nov 18;16(11):110173.
doi: 10.5312/wjo.v16.i11.110173.

Bilateral sleeve fracture of the superior pole of the patella in a healthy adult: A case report

Wen-Ping He  1 , Ci-Meng Ren  1 , Feng Luo  1 , Li Chen  1 , Wen-Tao Wang  1 , Bing-Tao Qiu  1 , Xiao-Cao Zhang  1 , Hai-Tao Chen  2
Affiliations
Case Reports

Bilateral sleeve fracture of the superior pole of the patella in a healthy adult: A case report

Wen-Ping He et al. World J Orthop. .

Abstract

Background: Sleeve fracture of the patella is an unusual fracture, almost unique to children. The majority of sleeve fractures involve the inferior patellar pole. However, sleeve fractures of the superior pole of the patella are extremely rare in adults.

Case summary: An 18-year-old male patient fell while running in the morning. The patient had tenderness to palpation at the superior pole of the patella, with a palpable gap over the upper part of the patella in both knees. We applied two 4.5-mm suture anchors with the Krackow stitch to repair the sleeve fracture, augmented by autogenous gracilis through performing the figure-of-eight technique. The patient regained approximately the full range of motion of the knee joint without any quadriceps weakness and a normal gait 6 weeks after surgery.

Conclusion: Sleeve fractures of the superior pole of the patella are extremely rare in adults, especially bilateral sleeve fractures. Suture anchors, augmented by autogenous gracilis, provided secure fixation and achieved excellent results in this rare injury.

Keywords: Adult; Case report; Patella; Sleeve fracture; Superior pole; Suture anchors.

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Conflict of interest statement

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Figures

Figure 1
Figure 1
Preoperative physical examination showed a palpable gap over the upper part of the patella in both knees.
Figure 2
Figure 2
Preoperative magnetic resonance imaging showed the bilateral sleeve fracture of the superior pole of the patella. A: Coronary magnetic resonance imaging (MRI) in the right knee; B: Sagittal MRI in the right knee; C: Coronary MRI in the left knee; D: Sagittal MRI in the left knee.
Figure 3
Figure 3
Preoperative and intraoperative photos. A: Patient in the supine position with an anterior approach incision in both knees; B-E: Intraoperative photographs. A thin shell of avulsed bone in the right knee (B); A thin shell of avulsed bone in the left knee (C); Two 4.5-mm suture anchors placed on the upper part of the patella in the right knee (D); The autogenous gracilis was applied to augment the stability by performing the figure-of-eight technique in the right knee (E).
Figure 4
Figure 4
Plain radiography of bilateral knee joints after surgery. A: Anteroposterior radiography of bilateral knee joints; B: Lateral radiography of right knee joint; C: Lateral radiography of left knee joint.
Figure 5
Figure 5
Follow-up at 6 weeks after surgery. A and B: Range of motion of bilateral knee joints; C and D: Gait of the patient.
See this image and copyright information in PMC

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