J Knee Surg 2018; 31(06): 490-497
DOI: 10.1055/s-0038-1625955
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Extensor Mechanism Injury in the Pediatric Population—A Clinical Review

William Cody Sessions
1  Department of Orthopedics, University of Minnesota, Minneapolis, Minnesota
Matthew Herring
1  Department of Orthopedics, University of Minnesota, Minneapolis, Minnesota
Walter H. Truong
2  Gillette Children's Specialty Healthcare, University of Minnesota, Minneapolis, Minnesota
› Author Affiliations
Further Information

Publication History

09 December 2017

19 December 2017

Publication Date:
06 February 2018 (online)


The extensor mechanism of the knee—consisting of the four muscles of the quadriceps, the quadriceps tendon, the patella, and the patellar ligament—is essential for lower extremity function during both standing and ambulation. The presence of articular cartilage and growing physes in the pediatric knee, coupled with the generation of significant tensile force, creates an opportunity for pathology unique to the pediatric population.

Tibial tubercle fractures and patella injuries are quite rare, and even pediatric-trained orthopaedic surgeons may not be exposed to these injuries on a regular basis. It is the intent of this article to discuss the current literature regarding the mechanism of injury, diagnostic workup, classification, indications for surgical versus non-surgical management, and techniques for operative management for both tibial tubercle and patella (transverse and sleeve) fractures.