Published online Nov 18, 2025. doi: 10.5312/wjo.v16.i11.110173
Revised: July 4, 2025
Accepted: September 25, 2025
Published online: November 18, 2025
Processing time: 168 Days and 2.4 Hours
Sleeve fracture of the patella is an unusual fracture, almost unique to children. The majority of sleeve fractures involve the inferior patellar pole. However, sleeve fractures of the superior pole of the patella are extremely rare in adults.
An 18-year-old male patient fell while running in the morning. The patient had tenderness to palpation at the superior pole of the patella, with a palpable gap over the upper part of the patella in both knees. We applied two 4.5-mm suture anchors with the Krackow stitch to repair the sleeve fracture, augmented by autogenous gracilis through performing the figure-of-eight technique. The patient regained approximately the full range of motion of the knee joint without any quadriceps weakness and a normal gait 6 weeks after surgery.
Sleeve fractures of the superior pole of the patella are extremely rare in adults, especially bilateral sleeve fractures. Suture anchors, augmented by autogenous gracilis, provided secure fixation and achieved excellent results in this rare injury.
Core Tip: Sleeve fractures of the superior pole of the patella were rare in adults. We report an extremely rare case of an 18-year-old man with a bilateral sleeve fracture of the superior pole of the patella that occurred after a sudden fall while running. The patient’s physical examination, imaging examinations, and surgical procedure are presented, along with relevant images. Suture anchors, augmented by autogenous gracilis, provided secure fixation and achieved excellent results in this rare injury.