Sleeve fracture of the patella in children.

PURPOSE To report the diagnosis, treatment, and outcomes of sleeve patellar fractures in children. METHODS Records of a consecutive series of patients with sleeve patellar fractures were retrospectively reviewed. RESULTS Of the 11 children (8 boys and 3 girls; mean age, 12 years), 6 had minimally displaced fractures (1-2 mm) and were managed by cylindrical plaster of Paris immobilisation, whereas the other 5 with severely displaced fractures underwent open reduction with tension band wiring. The mean follow-up period was 10 (range, 3-36) months. All patients obtained full extension of the knee except one (with an extension lag of 10 degrees). No patient complained of pain or discomfort of the involved knee. CONCLUSION Sleeve patellar fractures in children are uncommon. Diagnosis can be missed, especially in those with a very small avulsed bony fragment. For undisplaced fracture, conservative management can achieve good results. For severely displaced fractures, early surgical intervention is effective.