Abstract
Stress fracture of the patella is rare. In this report, a case of patellar stress fracture occurring in an amateur athlete is presented, and an operative adjunct to the surgical management of this condition is proposed.A review of the English literature identified 21 previous cases of stress fracture of the patella, the majority in young athletes. None of these reports discussed treatment addressing the pathological process contributing to patellar stress fracture.The subject of this case report is a young male netballer who presented with a transverse stress fracture in the inferior third of his patella, on a background of patellofemoral overload. The patient underwent open reduction and internal fixation of his patella, combined with release of the iliotibial band. He returned to training after 6 weeks.The previous literature suggests that operative fixation is indicated for the treatment of displaced patellar stress fractures. Iliotibial band release, as a surgical adjunct to this treatment, may address the pathology of these fractures, and facilitate a return to sport at the highest level.
Highlights
Stress fracture of the patella is rare, with only 21 cases previously reported in the English literature.[1,2,3,4,5,6,7,8,9,10,11,12,13] Patellofemoral contact stress, combined with tension from the extensor mechanism, leads to increased tensile stress on the anterior surface of the patella with subsequent microfracture and propagation
We report a case of displaced transverse stress fracture of the patella in an amateur athlete
The injury was sustained whilst jumping during a game of basketball. He was unable to continue playing, and weight bearing became difficult as swelling progressed. He had been diagnosed with patellofemoral pain syndrome on the basis of a 3 month history of anterior knee pain
Summary
Stress fracture of the patella is rare, with only 21 cases previously reported in the English literature.[1,2,3,4,5,6,7,8,9,10,11,12,13] Patellofemoral contact stress, combined with tension from the extensor mechanism, leads to increased tensile stress on the anterior surface of the patella with subsequent microfracture and propagation. In addition to operative fixation of the fracture, the patient underwent surgical release of his iliotibial band (ITB). This procedure (page number not for citation purposes). The injury was sustained whilst jumping during a game of basketball He was unable to continue playing, and weight bearing became difficult as swelling progressed. Preceding this injury, he had been diagnosed with patellofemoral pain syndrome on the basis of a 3 month history of anterior knee pain. There was no history of prior trauma or surgery to the knee He played representative indoor netball, social basketball, squash and he trained 6 days per week. The patient had a tight ITB, as assessed by the Iliotibial Band/Lateral Retinaculum test.[14]
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