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Advances in Orthopedics
Volume 2011, Article ID 428614, 4 pages
http://dx.doi.org/10.4061/2011/428614
Case Report

Bilateral Sleeve Fracture of the Inferior Poles of the Patella in a Healthy Child: Case Report and Review of the Literature

Pinderfields General Hospital, Aberford Road, Wakefield WF1 4DG, UK

Received 25 October 2010; Accepted 10 January 2011

Academic Editor: Virak Tan

Copyright © 2011 Stephen Paul Guy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The initial diagnosis of a sleeve fracture of the patella is key to a successful outcome with poor results well documented in the literature from delayed management. Diagnosis is difficult due to the rarity of this injury and thus the low likelihood the admitting junior doctor would think of this injury in their differential. They are very uncommon in incidence and have features on plain radiography that are difficult to interpret unless the surgeon is familiar with the anatomy of the immature patella. Missing the diagnosis can be disastrous for the patient. In this paper we describe the presentation of bilateral sleeve fractures in a healthy child, our initial investigations and subsequent management. We chose to repair with 5 Ethibond via 3 transosseous tunnels, initially reinforced with a circlage wire. On last review the boy maintains stable, pain-free knees with a full range of motion. The authors hope that this case and literature review will provide a valuable teaching aid and so assist in early, accurate diagnosis and cover the management options to achieve a positive outcome.