{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T02:15:44Z","timestamp":1791598544357,"version":"4.3.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T00:00:00Z","timestamp":1644451200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100017968","name":"Department of Orthopaedic Surgery, UCLA Health System","doi-asserted-by":"publisher","award":["Finerman Resident Grant"],"award-info":[{"award-number":["Finerman Resident Grant"]}],"id":[{"id":"10.13039\/100017968","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Inferior pole patellar sleeve fractures (PSFs) are rare injuries that occur in skeletally immature patients that may be missed or falsely diagnosed as an inferior pole fracture (IPF) or Sinding-Larsen-Johansson syndrome (SLJS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>The objective of this study was to evaluate and compare clinical and radiographic features of patients with PSF, IPF, and SLJS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cross-sectional study; Level of evidence, 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Retrospective review of skeletally immature patients diagnosed with PSF, IPF, and SLJS between 2011 and 2019 at a single urban academic center was performed. Chart and radiographic review was completed. Between-group differences were assessed using analysis of variance, Kruskal-Wallis test, and Fisher exact test, as appropriate to variable distributions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In total, 125 patients (82% male) were included, with a mean (SD) age of 10.7 (2) years (16 PSF, 51 IPF, 58 SLJS). There were no significant differences in patient characteristics between the 3 groups. One hundred percent of the patients with PSF ( P &lt; .001) and IPF ( P &lt; .001) had acute trauma, compared with 24% of patients with SLJS. Fewer patients with PSF had an intact straight leg raise (38%) compared with those with IPF (94%; P &lt; .001) and SLJS (98%; P &lt; .001). Fewer patients with SLJS had knee swelling (41%) compared with those with PSF (93%; P &lt; .001) and IPF (94%; P &lt; .001). More patients with PSF had knee effusion (81%) compared with those with IPF (37%; P = 0.011) and SLJS (3%; P &lt; .001). More patients with SLJS were able to bear weight (88%) compared with those with IPF (12%; P &lt; .001) and PSF (0; P &lt; .001). Radiographically, compared with those with IPF and SLJS, patients with PSFs had increased mean prepatellar swelling (6.1 [ P &lt; .001] and 6.5 [ P &lt; .001] vs 12.9 mm), intra-articular effusion (6.1 [ P = .014] and 4.9 [ P = .001] vs 9.2 mm), maximum fragment size (26 [ P = .004] and 17.7 [ P &lt; .001] vs 45.3 mm), and maximum fragment displacement (1.24 [ P = .002] and 1.45 [ P = .003] vs 13.30 mm), respectively. Compared with those with SLJS (1.10), patients with PSF (1.92; P &lt; .001) and IPF (1.22; P &lt; .001) had patella alta with higher mean Insall-Salvati ratios &gt;1.2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Differences in clinical features such as ability to straight leg raise, knee swelling, knee effusion, ability to bear weight, and radiographic features, such as prepatellar swelling, intra-articular effusion, fragment displacement\/size\/shape\/location, and patellar height, can all be helpful in recognizing rare pediatric inferior patellar pathology, thus increasing efficiency in indicating for higher-level imaging to reach a prompt diagnosis and provide appropriate treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465221073995","type":"journal-article","created":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T07:55:46Z","timestamp":1644479746000},"page":"977-983","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Clinical and Radiographic Differentiation of Pediatric Patellar Sleeve Fractures and Other Inferior Pole Pathologies"],"prefix":"10.1177","volume":"50","author":[{"given":"Sai K.","family":"Devana","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA"},{"name":"Orthopedic Institute for Children\u2019s Center for Sports Medicine, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andromahi","family":"Trivellas","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, David 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