Patellar Sleeve Fracture: Open Reduction and Internal Fixation

Abstract

Patellar sleeve fractures are a rare injury comprising less than 1% of all pediatric fractures. They are characterized by an outer sleeve of cartilage pulled away from the osseous patella. The most common pattern is an osteochondral fracture at the inferior patellar pole but lateral or medial based injuries are also reported. Multiple fixation methods are described, depending on fracture pattern, osseous fragment size, and surgeon preference. The specific technique of patellar sleeve fixation utilizing transosseous suture placement is described and illustrated with an accompanying video.