[Patellar sleeve fractures : Bracing and augmentation technique with suture tape].

OBJECTIVE: Transosseous augmentation of patellar sleeve fractures (PSF) with suture tape in young athletes.

INDICATIONS: Acute avulsions of the proximal or distal patellar pol with clinical relevant deficit of knee extension.

CONTRAINDICATIONS: Local infections, severe soft tissue damage (relative contraindication), fractures of the patella or tibial tuberosity.

SURGICAL TECHNIQUE: Direct longitudinal anterior approach to the patella. Debridement of the proximal patellar tendon insertion. Anatomic reduction of any osteochondral fragments. Transosseous augmentation of the tendon with FiberTapes® (Arthrex, Naples, FL, USA).

POSTOPERATIVE MANAGEMENT: Passive motion exercise to 30° of flexion from day 1; increase to 60° from week 3; 90° from week 5. Partial load-bearing of 20 kg with knee in locked full extension brace during first 2 weeks. Isometric exercises from week 3. Free active ROM and full weight bearing from week 7.

RESULTS: If diagnosis and treatment is early and sufficient augmentation of the tendon and periosteum is provided, good to excellent functional outcome can be expected.