Archives of Orthopaedic and Trauma Surgery

, Volume 133, Issue 4, pp 517–521 | Cite as

Bifocal disruption of the knee extensor mechanism: a case report and literature review

  • Suk Kang
  • Phil Hyun Chung
  • Young Sung Kim
  • Ho Min Lee
  • Jong Pil Kim
Trauma Surgery

Abstract

Bifocal disruption of the knee extensor mechanism is a rare injury. Bifocal proximal and distal avulsion fracture of the patella tendon is extremely rare in adults. Here, the authors report the case of an 84-year-old male patient who developed simultaneous avulsion fracture of the patella tendon from the inferior pole of the patella and the tibial tuberosity. Open reduction and internal fixation were performed, and at 12 months postoperatively, an excellent functional result was obtained.

Keywords

Bifocal disruption Knee extensor mechanism Patella tendon Avulsion fracture 

References

  1. 1.
    Chautems R, Michel J, Barraud GE, Burdet A (2001) Bifocal avulsion of the patellar tendon in an adult: a case report. Rev Chir Orthop Reparatrice Appar Mot 87:388–391PubMedGoogle Scholar
  2. 2.
    Berg EE (1995) Bipolar infrapatellar tendon rupture. J Pediatr Orthop 15:302–303PubMedCrossRefGoogle Scholar
  3. 3.
    Chappius J, Penders W, Cherchel A, Lamraski G (2011) Bifocal disruption of the knee extensor apparatus(floating patella) in a 72-year-old patient. Acta Orthop Belg 77:548–551Google Scholar
  4. 4.
    Frankl U, Wasilewski SA, Healy WL (1990) Avulsion fracture of the tibial tubercle with avulsion of the patella ligament. report of two cases. J Bone Joint Surg Am 72:1411–1413PubMedGoogle Scholar
  5. 5.
    Goodier D, Maffulli N, Good J (1994) Tibial tuberosity avulsion associated with patella tendon avulsion. Acta Orthop Belg 60:235–237PubMedGoogle Scholar
  6. 6.
    Huber B, Reichenkendler M, Gschwentner M, Kralinger F (2006) Bifocal disruption of the knee extensor apparatus(floating patella) in a 13-year-old patient. Arch Orthop Trauma Surg 126:275–278PubMedCrossRefGoogle Scholar
  7. 7.
    Kaneko K, Miyazaki H, Yamaguchi T (2000) Avulsion fracture of the tibial tubercle with avulsion of the patella ligament in an adolescent female athlete. Clin J Sports Med 10:144–145CrossRefGoogle Scholar
  8. 8.
    Kramer DE, Chang TL, Miller NH, Sponseller PD (2008) Tibial tubercle fragmentation: a clue to simultaneous patella ligament avulsion in pediatric tibial tubercle fractures. Orthopedics 31:501PubMedCrossRefGoogle Scholar
  9. 9.
    Mayba II (1982) Avulsion fracture of the tibial tubercle apophysis with avulsion of patellar ligament. J Pediatr Orthop 2:303–305PubMedCrossRefGoogle Scholar
  10. 10.
    Mosier SM, Staniski CL (2004) Acute tibial tubercle avulsion fractures. J Pediatr Orthop 24:181–184PubMedCrossRefGoogle Scholar
  11. 11.
    Peterson L, Stener B (1976) Distal disinsertion of the patella ligament combined with avulsion fractures at the medial and lateral margins of the patella. a case report and an experimental study. Acta Orthop Scand 47:680–685PubMedCrossRefGoogle Scholar
  12. 12.
    Sie EJ, Kacou AD, Sery BL, Lambin Y (2011) Avulsion fracture of the tibial tubercle associated with patella ligament avulsion treated by staples. Afr J Paediatr Surg 8:105–108PubMedCrossRefGoogle Scholar
  13. 13.
    Schiedts D, Mukisi M, Bastaraud H (1995) Fractures of the tibial tuberosity associated with avulsion of the patella ligament in adolescents. Rev Chir Orthop Reparatrice Appar Mot 81:635–638PubMedGoogle Scholar
  14. 14.
    Sullivan L, Lee CB, Simonian PT (2000) Simultaneous avulsion fracture of the tibial tubercle with avulsion of the patella ligament. Am J Knee Surg 13:156–158PubMedGoogle Scholar
  15. 15.
    Swan K Jr, Rizio L (2007) Combined avulsion fracture of the tibial tubercle and avulsion of the patella ligament. Orthopedics 30:571–572PubMedGoogle Scholar
  16. 16.
    Yoon JR, Kim TS, Kim HJ, Nor HK, Oh JK, Yoo JC (2007) Simultaneous patellar tendon avulsion fracture from both patella and tibial tuberosity: a case report. Knee Surg Sports Traumatol Arthrosc 15:225–227PubMedCrossRefGoogle Scholar
  17. 17.
    Langer PR, Selesnick FH (2010) Floating patella combined quadriceps tendon, retinacula, and patellar tendon ruptures in a high-performance elite athlete. Am J Orthop 39:446–449PubMedGoogle Scholar
  18. 18.
    Bonatus TJ, Alexander AH (1991) Patella fracture and avulsion of the patella ligament complicating arthroscopic anterior cruciate ligament reconstruction. Orthop Rev 20:770–774PubMedGoogle Scholar
  19. 19.
    Kuo MH, Leong CP, Wang CJ (2003) Simultaneous patellar fracture and patellar tendon avulsion following arthroscopic anterior cruciate ligament reconstruction: a case report and literature review. Chang Gung Med J 26:592–597PubMedGoogle Scholar
  20. 20.
    Miller MD, Nichols T, Buttler C (1999) Patella fracture and proximal patellar tendon rupture following arthroscopic anterior cruciate ligament reconstruction. Arthroscopy 15:640–643PubMedCrossRefGoogle Scholar
  21. 21.
    Yang KH, Byun YS (2003) Separate vertical wiring for the fixation of comminuted fractures of the inferior pole of the patella. J Bone Joint Surg Br 85:1155–1160PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Suk Kang
    • 1
  • Phil Hyun Chung
    • 1
  • Young Sung Kim
    • 1
  • Ho Min Lee
    • 1
  • Jong Pil Kim
    • 1
  1. 1.Department of Orthopaedic Surgery, College of MedicineDongguk UniversityGyeongjuRepublic of Korea

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