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Multifragment fracture of the patellar apex with extensive loss of skin: A case report

Patella fractures account for 1 % of all skeletal fractures, and can interrupt the knee's extensor apparatus. They can also be serious if associated with a cutaneous opening. We report the case of a fracture of the tip of the patella with a large loss of cutaneous substance. A 22-year-old man w...

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Bibliographic Details
Published in:Trauma case reports 2024-08, Vol.52, p.101051, Article 101051
Main Authors: Barrached, Mohammed, Abdou, Aboubacar Lawan, el Hassali, Achraf Tebbaa, Lachkar, Adnane, Abdeljaouad, Najib, Yacoubi, Hicham
Format: Article
Language:English
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Summary:Patella fractures account for 1 % of all skeletal fractures, and can interrupt the knee's extensor apparatus. They can also be serious if associated with a cutaneous opening. We report the case of a fracture of the tip of the patella with a large loss of cutaneous substance. A 22-year-old man was admitted for the management of a left knee trauma following a motorcycle accident. Clinical examination revealed a large loss of skin substance on the anteromedial aspect of the knee, with exposed bone, pain and lack of extension of the left knee. Standard X-ray of the left knee showed an avulsion fracture of the tip of the patella. The patient underwent patellar tendon reconstruction using transosseous stitches, reinforced by a quadricipital tendon reversal plasty, and protected by steel-wire patellotibial cerclage. A medial gastrocnemius flap was used to cover the loss of skin substance. After a functional rehabilitation protocol, the functional results were satisfactory, with a full return to activity after six months. The stability of osteosynthesis using quadricipital tendon reversal plasty and patellotibial cerclage allows mobilization and immediate weight-bearing. This may lead to better clinical results.
ISSN:2352-6440
2352-6440
DOI:10.1016/j.tcr.2024.101051