Vertical Patellar Dislocation: Reduction by the Push Up and Rotate Method, A Case Report and Literature Review

A Rare Case of Vertical Patella Dislocation Reduced by Closed Reduction

Vertical patella dislocation or "dorsal fin patella" is a rare but potentially debilitating orthopedic condition characterized by the displacement of the kneecap in a vertical direction. It occurs when the patella moves out of its normal position within the trochlear groove of the femur, rotating along its vertical axis resulting in the articular surface facing either medially or laterally. The mechanism of injury is primarily through axial rotation injury at the knee but could also occur secondary to a medial or lateral trauma to the patella. This dislocation can cause significant pain, immobility, and instability of the knee joint. Closed reduction to restore the patella to its proper alignment is a non-surgical technique that is uncommonly employed to treat vertical patella dislocations due to the inherent risk of osteochondral lesions. Here, we present a case of a 39-year-old male with a vertical patella dislocation after sustaining a traumatic blow to the knee during a Jiu-jitsu sparring exercise with a partner. This injury was successfully managed by a closed reduction in the emergency department.

A Low-Energy Patella Vertical Dislocation in an Adolescent: A Case Report

Intra-articular dislocation of the patella is considered a rare case where it was reported that limited cases are existing in the literature and the exact mechanism of the injury is still undetermined. Patellar dislocation is divided into extra-articular and intra-articular dislocation. We report a patient with vertical dislocation of the patella caused by a low-energy injury that is very rare according to the previous study. The patient came with a deformity, skin tenting, and pain with pressure on the superior and medial sides of the patella. During the physical examination, a deformation of skin tenting was observed with the characteristic of a "dorsal-fin" appearance over the laterally displaced patella. This paper will discuss the dislocation of the patella, which can be further classified into extra-articular and intra-articular. Vertical patellar dislocation most commonly occurred in adolescence. The outcome was considered satisfactory, and this case provides further knowledge of the mode of injury of vertical dislocation and also the possible risk factors.

Superior Dislocation of the Patella in a Young Patient without Osteophytes: A Case Report with Discussion about Differential Diagnosis

We report a case of superior dislocation of the patella in a young woman without degenerative changes. We retrospectively analyzed the clinical and imaging data obtained from the patient. This article describes a rare case of patellar dislocation following a bicycle fall in a 19-year-old woman without any history of patellofemoral complaints. Our literature search yielded 28 case reports; however, most reports describe older individuals with osteoarthritis. Only two reports have previously described this lesion in young patients without osteophytes, but some features, like an increase of the patella tilt, may raise doubts about whether it would be better to classify them as a vertical dislocation of the patella, another quite rare lesion, or just as a variant of a superior dislocation.

Unusual Horizontal Patellar Dislocation Reduced without General Anesthesia: A Report of 2 Cases

CASE

Horizontal patellar dislocation is a rare clinical event, and there is no consensus on its management. We describe 2 relatively elderly patients with 2 different types of horizontal patellar dislocation who were successfully treated with closed reduction without general anesthesia.

CONCLUSION

Appropriate and gently managed closed reduction without general anesthesia may be successful in cases of acute horizontal patellar dislocation, provided there are no osteophytes or an injury that requires surgical treatment. With closed reduction and subsequent rehabilitation, patients can regain functional capacity quickly.