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Pediatric update # 13. Injuries to the inferior pole of the patella in children
J S Gardiner1, V K McInerney, D G Avella
1Seton Hall University, School of Graduate Medical Education, South Orange, New Jersey.
Insights
Sinding-Larsen-Johansson disease is chronic tendinitis with calcification, while sleeve fractures are acute avulsions of the patellar tendon in children. Both affect the inferior patella.
Area of Science:
- Pediatric orthopedics
- Sports medicine
- Pediatric sports injuries
Background:
- Sinding-Larsen-Johansson disease and sleeve fractures are distinct pediatric knee injuries.
- Both conditions affect the inferior pole of the patella.
- Understanding their differences is crucial for accurate diagnosis and treatment.
Observation:
- Sinding-Larsen-Johansson disease involves chronic patellar tendinitis with calcification.
- Sleeve fractures are acute injuries with complete patellar tendon avulsion.
- These fractures may include bone flecks and articular cartilage.
Findings:
- The study differentiates between chronic tendinitis (Sinding-Larsen-Johansson disease) and acute avulsion fractures (sleeve fractures).
- Case histories illustrate the presentation and characteristics of each injury.
- A literature review supports the distinction and understanding of these conditions.
Implications:
- Accurate differentiation aids in appropriate management strategies for pediatric knee pain.
- Improved diagnostic clarity can lead to better patient outcomes.
- This knowledge is vital for orthopedic surgeons and sports medicine professionals treating young athletes.
Abstract:
Sinding-Larsen-Johansson disease and sleeve fractures are two injuries that occur at the inferior pole of the patella in children. The first is a chronic tendinitis accompanied by calcification of the avulsed patellar tendon. The latter are acute injuries that involve a complete avulsion of the proximal insertion of the patellar tendon with a small fleck of bone and portion of patellar articular cartilage. Illustrative case histories and a literature review are presented.