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

Introduction: 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. Case...

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Main Authors: Mohammed Barrached, Aboubacar Lawan Abdou, Achraf Tebbaa el Hassali, Adnane Lachkar, Najib Abdeljaouad, Hicham Yacoubi
Format: Article
Language:English
Published: Elsevier 2024-08-01
Series:Trauma Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352644024000748
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author Mohammed Barrached
Aboubacar Lawan Abdou
Achraf Tebbaa el Hassali
Adnane Lachkar
Najib Abdeljaouad
Hicham Yacoubi
author_facet Mohammed Barrached
Aboubacar Lawan Abdou
Achraf Tebbaa el Hassali
Adnane Lachkar
Najib Abdeljaouad
Hicham Yacoubi
author_sort Mohammed Barrached
collection DOAJ
description Introduction: 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. Case report: 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. Conclusion: 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.
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publishDate 2024-08-01
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spelling doaj-art-7d24e3ea9c1b487bae7cfc78a937ab5f2025-08-20T03:20:33ZengElsevierTrauma Case Reports2352-64402024-08-015210105110.1016/j.tcr.2024.101051Multifragment fracture of the patellar apex with extensive loss of skin: A case reportMohammed Barrached0Aboubacar Lawan Abdou1Achraf Tebbaa el Hassali2Adnane Lachkar3Najib Abdeljaouad4Hicham Yacoubi5Corresponding author at: Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco.; Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco; Department of Traumatology and Orthopedic, Mohammed VI University Hospital, Oujda, MoroccoFaculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco; Department of Traumatology and Orthopedic, Mohammed VI University Hospital, Oujda, MoroccoFaculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco; Department of Traumatology and Orthopedic, Mohammed VI University Hospital, Oujda, MoroccoFaculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco; Department of Traumatology and Orthopedic, Mohammed VI University Hospital, Oujda, MoroccoFaculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco; Department of Traumatology and Orthopedic, Mohammed VI University Hospital, Oujda, MoroccoFaculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco; Department of Traumatology and Orthopedic, Mohammed VI University Hospital, Oujda, MoroccoIntroduction: 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. Case report: 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. Conclusion: 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.http://www.sciencedirect.com/science/article/pii/S2352644024000748KneeFracture of the patellar apexSkin lossPatellotibial cerclageGastrocnemius flap
spellingShingle Mohammed Barrached
Aboubacar Lawan Abdou
Achraf Tebbaa el Hassali
Adnane Lachkar
Najib Abdeljaouad
Hicham Yacoubi
Multifragment fracture of the patellar apex with extensive loss of skin: A case report
Trauma Case Reports
Knee
Fracture of the patellar apex
Skin loss
Patellotibial cerclage
Gastrocnemius flap
title Multifragment fracture of the patellar apex with extensive loss of skin: A case report
title_full Multifragment fracture of the patellar apex with extensive loss of skin: A case report
title_fullStr Multifragment fracture of the patellar apex with extensive loss of skin: A case report
title_full_unstemmed Multifragment fracture of the patellar apex with extensive loss of skin: A case report
title_short Multifragment fracture of the patellar apex with extensive loss of skin: A case report
title_sort multifragment fracture of the patellar apex with extensive loss of skin a case report
topic Knee
Fracture of the patellar apex
Skin loss
Patellotibial cerclage
Gastrocnemius flap
url http://www.sciencedirect.com/science/article/pii/S2352644024000748
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