Answer:
Patellar Sleeve Avulsion fracture .
Findings:
There is Avulsion of small bony fragment from distal pole of patella, together with articular cartilage , periosteum and retinaculum. quadriceps tendon is relatively thickened.
Discussion:
Patellar sleeve avulsion fracture is a type of osteochondral fracture of the patella which results due to high impact jumping activities. The mechanism is eccentric contraction of the quadriceps on the flexed knee. It occurs when the inferior pole of the patella of a child or adolescent is pulled off together with a large amount of articular cartilage and retinaculum. It needs open reduction and internal fixation . The main differential diagnosis is Sinding Larsen Disease where there is only Bone Avulsion at proximal patellar insertion. Thickened and hyperintense proximal patellar tendon and calcification /ossification at junction of patella and ligament may be seen. It could be managed conservatively in contrast to former.
Contributed By:
Dr. Babu Peter MD, DNB
Associate Professor, Barnard Institute of Radiology, Chennai
Senior Consultant Radiologist, Aarthi Scans, Chennai
Patellar Sleeve Avulsion fracture .
Findings:
There is Avulsion of small bony fragment from distal pole of patella, together with articular cartilage , periosteum and retinaculum. quadriceps tendon is relatively thickened.
Discussion:
Patellar sleeve avulsion fracture is a type of osteochondral fracture of the patella which results due to high impact jumping activities. The mechanism is eccentric contraction of the quadriceps on the flexed knee. It occurs when the inferior pole of the patella of a child or adolescent is pulled off together with a large amount of articular cartilage and retinaculum. It needs open reduction and internal fixation . The main differential diagnosis is Sinding Larsen Disease where there is only Bone Avulsion at proximal patellar insertion. Thickened and hyperintense proximal patellar tendon and calcification /ossification at junction of patella and ligament may be seen. It could be managed conservatively in contrast to former.
Contributed By:
Dr. Babu Peter MD, DNB
Associate Professor, Barnard Institute of Radiology, Chennai
Senior Consultant Radiologist, Aarthi Scans, Chennai