Department of Emergency Medicine, Kaohsiung Veteran General Hospital, Kaohsiung, Taiwan, ROC.
J Chin Med Assoc. 2011 Feb;74(2):98-101. doi: 10.1016/j.jcma.2011.01.020. Epub 2011 Feb 12.
Patella sleeve fracture is a rare fracture that only occurs in children. Diagnosis is difficult both clinically and radiologically. A high-riding patella and hemarthrosis are important signs when diagnosing this fracture. We report a case of an 11-year-old boy who suffered from patella sleeve fracture without visible bony fragments on a lateral radiograph. Open reduction with transosseous tunneling and patellotibial cerclage wiring for anastomosis protection was performed. Early weight bearing was achieved together with a satisfactory range of knee motion. Premature anterior physeal arrest was noted because of insertion of cerclage wire in the open physis. However, no genu recurvatum was present 2 years after the initial operation. An awareness of sleeve fracture, together with its characteristic clinical and radiological features, is important to avoid misdiagnosis and treatment delay. If the cerclage wire technique is used, care should be taken not to disturb the proximal tibial apophysis.
髌骨袖套骨折是一种罕见的骨折，仅发生在儿童中。临床和影像学诊断都很困难。高位髌骨和关节积血是诊断这种骨折的重要征象。我们报告了一例 11 岁男孩的髌骨袖套骨折病例，其侧位 X 线片未见明显骨碎片。采用经骨隧道切开复位和髌腱-胫腓骨环扎线吻合保护进行治疗。早期负重并获得了满意的膝关节活动度。由于在开放骨骺中插入了环扎线，出现了过早的前骺端阻滞。然而，初次手术后 2 年，没有出现膝反屈。了解袖套骨折及其特征性的临床和影像学特征对于避免误诊和治疗延误非常重要。如果使用环扎线技术，应注意不要干扰胫骨近端骨骺。
