Patella gigantism following traditional bonesetter treatment

Abstract

The patella is the largest human sesamoid bone, lies within, and is an important component of the knee extensor mechanism. Tumors and tumor-like lesions of the patella are rare. Fractures of the patella are relatively uncommon and account for 1% of all musculoskeletal system fractures. These fractures can be managed by traditional bonesetters with attendant complications. To report a case of patella gigantism following a patella fracture which was treated by a traditional bonesetter. An 18-year-old male Nigerian presented with a 2-year history of anterior left knee swelling following a motorcycle accident. A diagnosis of closed patella fracture was made, but he declined orthodox treatment. Treatment had been from traditional bonesetters who were massaging the knee regularly for about 2 years. Clinical and radiographic examinations revealed an enlarged patella. He had patellectomy and reconstruction of the extensor mechanism of the left knee. The patella measured 22 cm × 18 cm and weighed 0.5 kg, which was regarded as a giant patella. Histopathological report of the excised patella revealed patella sclerosis. He made an uneventful recovery and presently walks about unaided. Patella gigantism can occur following treatment of patella fracture by traditional bonesetters. We recommend patellectomy and reconstruction of the extensor mechanism, whenever a giant patella is encountered.