PMC3170764_01
Clinical appearance of the knees on initial presentation.
AOP2011-428614.001.jpg
PMC3170764_01_AOP2011-428614.001.jpg
fig1
He attended hospital with bilateral knee pain with significant effusions, the left being larger clinically than the right (Figure 1).
(a) AP radiograph of the right knee. (b) Lateral radiograph of the right knee. (c) AP radiograph of the left knee. (d) Lateral radiograph of the left knee.
AOP2011-428614.002.jpg
PMC3170764_01_AOP2011-428614.002.jpg
fig2
Radiographs of the knees were suspicious of sleeve fractures (Figures 2(a)-2(d)) and an MRI of both knees was organised.
Sagittal T2 MRI of the right knee.
AOP2011-428614.003.jpg
PMC3170764_01_AOP2011-428614.003.jpg
fig3
The MRI clearly revealed the extent of the displaced sleeve fractures (Figure 3).
(a) Intra-operative image of the right knee. (b) Intra-operative image of the left knee.
AOP2011-428614.004.jpg
PMC3170764_01_AOP2011-428614.004.jpg
fig4
The construct was reinforced with a circlage wire, passing through the tibial tuberosity and above the superior pole of the patella, with the wire twisted so that it could be retrieved later through a small incision (Figures 4(a) and 4(b)).