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Review Question - QID 6077

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QID 6077 (Type "6077" in App Search)
An 11-year-old basketball player reports that he felt a painful pop in the left knee when he stumbled while running. He is unable to bear weight on the extremity and cannot actively extend the knee against gravity. Examination reveals a large knee effusion. A lateral radiograph is shown in Figure 7. Management should consist of
  • A

physical therapy for quadriceps strengthening exercises.

1%

6/656

a long leg cast with the knee fully extended.

4%

24/656

excision of the fragment.

1%

5/656

suture reattachment of the patellar tendon to the tibial tuberosity.

35%

232/656

open reduction and tension band fixation.

58%

380/656

  • A

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The radiograph shows an avulsion fracture, or “sleeve fracture,” of the distal pole of the patella. The distal fragment is much larger than it appears on the radiograph because it largely consists of cartilage; therefore, excision of the fragment is contraindicated. The treatment of choice is open reduction and tension band fixation to correct patella alta and restore the extensor mechanism.

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