Management and subsequent outcomes of patellar sleeve injuries: A retrospective case series of 90 pediatric and adolescent patients.

Autor:	Yellin JL; Division of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, PA, USA., Feroe AG; Division of Sports Medicine, Boston Children's Hospital, Boston, MA, USA.; Department of Orthopaedics, Mayo Clinic, Rochester, MN, USA., Watkins IT; Division of Sports Medicine, Boston Children's Hospital, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA., Franco H; Division of Sports Medicine, Boston Children's Hospital, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA., Guevel B; Division of Sports Medicine, Boston Children's Hospital, Boston, MA, USA., Haber DB; Panorama Orthopedics & Spine Center, Westminster, CO, USA., Kocher MS; Division of Sports Medicine, Boston Children's Hospital, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	Journal of children's orthopaedics [J Child Orthop] 2024 Feb 07; Vol. 18 (2), pp. 208-215. Date of Electronic Publication: 2024 Feb 07 (Print Publication: 2024).
DOI:	10.1177/18632521241228167
Abstrakt:	Purpose: This study aims to report the epidemiology of patellar sleeve injuries, describe diagnostic findings and treatment, and assess functional outcomes following different treatments. Methods: A medical database was queried from 1990 to 2016 to identify patients ≤18 years presenting to a single pediatric institution with a patellar sleeve injury. Patients with significant comorbidities or previously operatively treated for ipsilateral knee injuries were excluded. Standard demographic data, mechanism of injury, skeletal maturity, injury-related radiographic parameters, along with treatment paradigms, post-treatment clinical and radiographic findings, and patient-reported outcomes were collected. Results: A total of 90 patients, mean age of 10.7 years (range: 7-17) was included, of which 69 (77%) were male. Seventy-three percent of all injuries occurred while playing sports (particularly football/basketball/soccer), with "direct blow" or "landing" being the most prevalent mechanisms of injury. Twenty-six (29%) underwent operative treatment, with transosseous suture fixation being the most popular surgical technique (73%). Of the 64 (71%) non-operatively treated patients, 18 (39%) were placed in a hinged knee brace locked in extension with the remainder split between casting and standard knee immobilizer. Compared to the non-operative cohort, a higher percentage of the operative group had a pre-treatment extensor lag (p < 0.001) and greater fragment displacement (p < 0.001) with patella alta (p < 0.001) on imaging. There was no difference in outcome scores (Pedi-IKDC/Lysholm) or patella alta on radiographs between groups. Post-treatment surveys indicated no difference in residual pain or ability to return to sport. Conclusion: This large case series provides valuable epidemiologic, clinical, and radiographic data describing patellar sleeve fractures, along with outcomes following non-operative and operative treatments. Level of Evidence: IV. Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. (© The Author(s) 2024.)
Databáze:	MEDLINE
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