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Pediatric Patellar Sleeve Fracture S82.009A 822.0

synonyms: Pediatric patellar fracture

Pediatric Patellar Sleeve Fracture ICD-10

 

A- initial encounter for closed fracture

B- initial encounter for open fracture

C-initial encounter for open fracture type IIIA, IIIB, or IIIC

D- subsequent encounter for fracture with routine healing

E- subsequent encounter for open fracture type I or II with routine healing

F- subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing

G- subsequent encounter for fracture with delayed healing

H- subsequent encounter for open fracture type I or II with delayed healing

J- subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing

K- subsequent encounter for fracture with nonunion

M- subsequent encounter for open fracture type I or II with nonunion

N- subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion

P- subsequent encounter for fracture with malunion

Q- subsequent encounter for open fracture type I or II with malunion

R- subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion

S- sequela

Pediatric Patellar Sleeve Fracture ICD-9

  • 822.0 (fracture of patella, closed)
  • 822.1 (open)

Pediatric Patellar Sleeve Fracture Etiology / Epidemiology / Natural History

  • patellar sleeve fracture.  The patellar tendon avulses a portion of the distal bony patella, along with the retinaculum and articular cartilage from the inferior pole of the patella.
  • common in children between ages 8 and 10 years. 

Pediatric Patellar Sleeve Fracture Anatomy

  • Proximal avulsed fragments generally contain a significant portion of cartilage, which is not seen on xray.

Pediatric Patellar Sleeve Fracture Clinical Evaluation

  • Loss of active knee extension
  • Effusion, knee pain

Pediatric Patellar Sleeve Fracture Xray / Diagnositc Tests

  • A/P and lateral views of the knee. May demonstrate fragment of bone pulled away from patalla and patella alta or patella baja.

Pediatric Patellar Sleeve Fracture Classification / Treatment

  • Anatomic reduction and repair of the extensor mechanism are mandatory to reestablish full knee extension.   Repair generally done between bony fragments, through bone tunnels in the larger fragment

Pediatric Patellar Sleeve Fracture Associated Injuries / Differential Diagnosis

Pediatric Patellar Sleeve Fracture Complications

  • Infection
  • Nonunion
  • Malunion
  • Painful hardware

Pediatric Patellar Sleeve Fracture Follow-up Care

Pediatric Patellar Sleeve Fracture Review References

  1. Houghton GR, Ackroyd CE: Sleeve fractures of the patella in children: A report of three cases.  J Bone Joint Surg Br 1979;61:165-168.
  2. Wu CD, Huang SC, Liu TK: Sleeve fracture of the patella in children: A report of five cases.  Am J Sports Med 1991;19:525-528
  3. Maguire JK, Canale ST: Fractures of the patella in children and adolescents. JPO 1993;13:567-571
  4. Grogan DP, JPO 1990;10:721
  5. Lovell and Winter's Pediatric Orthopaedics 2012
  6. Gettys FK, Morgan RJ, Fleischli JE. Superior pole sleeve fracture of the patella: a case report and review of the literature. Am J Sports Med. 2010 Nov;38(11):2331-6. 
  7. Maripuri SN, Mehta H, Mohanty K. Sleeve fracture of the superior pole of the patella with an intra-articular dislocation. A case report. J Bone Joint Surg Am. 2008 Feb;90(2):385-9

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