title: An isolated articular surface fracture of the distal patella: an unusual and previously unreported paediatric injury.
abstract: Paediatric patella fractures are uncommon, accounting for less than 1% of all paediatric fractures. This case report describes a previously undocumented patella fracture in a child, with a clear mechanism of injury. We present a case of a previously healthy 14-year-old boy who fell directly onto his right knee after coming off his pushbike. He sustained an isolated fracture involving the articular surface of the distal part of the patella with minimal displacement. The patient was managed conservatively in a Richard splint for three weeks, followed by a knee brace with gradually increasing degrees of flexion. He was instructed to be nonweight bearing for two weeks and then partial weight bearing for six weeks. At the final followup, after 9 weeks, the patient had full return of function and standard radiographs show the fracture to be healed. This case report has demonstrated how direct compression to the paediatric patella can cause a fracture isolated to its articular surface. It has detailed the natural progression of this injury to radiographic union, using a conservative management strategy. The authors believe that this case report provides an interesting insight into the variation of paediatric patella fractures and their contrasting management strategies.
authors.affiliation: Queen's Medical Centre, Derby Road, Nottingham NG7 2UH, UK.
authors.forename: Faiz S
authors.initials: FS
authors.lastname: Shivji
authors.affiliation: Queen's Medical Centre, Derby Road, Nottingham NG7 2UH, UK.
authors.forename: Darryl N
authors.initials: DN
authors.lastname: Ramoutar
authors.affiliation: Queen's Medical Centre, Derby Road, Nottingham NG7 2UH, UK.
authors.forename: James B
authors.initials: JB
authors.lastname: Hunter