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Frederick N. Meyer, MD, Albert
W. Pearsall, IV, MD, Sudhakar Madanagopal, MD, Jared J. Patterson,
MD, University of South Alabama Medical Center
Dislocations of the patella occur
predominantly laterally, with intercondylar and intraarticular
dislocations occurring less frequently. Superior dislocations
of the patella are rare, with only five cases reported in
the world literature. Previously described mechanisms have
included engagement of patellar and femoral condylar osteophytes.
We report the cases of a 22-year
old female who presented with a compliant of right knee pain
after she fell with an inability to bend her knee due to pain.
Initial radiographic evaluation of the knee revealed a lateral
dislocation of the patella. Closed reduction was attempted
in the emergency room under conscious sedation. Post-reduction
radiographs revealed that the patella was located superolaterally,
locked on the lateral femoral condyle. The patient was taken
to the operating room and the patella reduced uneventfully
under general anesthesia. Post-reduction, the patellar tendon
was palpated and remained intact, confirming the diagnosis
of superior dislocation of the patella and not patellar tendon
rupture. The patient was able to actively flex and extend
her knee without difficulty. The patient did well at time
of discharge.
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