case_images: PMC9897702_01
case_images: Anterior-posterior radiograph of the left knee showing a lateral patellar dislocation
case_images: cureus-0015-00000033415-i01.jpg
case_images: PMC9897702_01_cureus-0015-00000033415-i01.jpg
case_images: FIG1
case_images: Radiographs demonstrated a laterally displaced left patellar dislocation (Figures 1, 2).
case_images: Lateral radiograph of the left knee showing a patellar dislocation
case_images: cureus-0015-00000033415-i02.jpg
case_images: PMC9897702_01_cureus-0015-00000033415-i02.jpg
case_images: FIG2
case_images: Radiographs demonstrated a laterally displaced left patellar dislocation (Figures 1, 2).
case_images: Modified sunrise (patient unable to bend the knee) radiograph of the left knee showing lateral patellar dislocation with medial patellar impaction defect and avulsion fracture of the medial patella
case_images: cureus-0015-00000033415-i03.jpg
case_images: PMC9897702_01_cureus-0015-00000033415-i03.jpg
case_images: FIG3
case_images: Careful evaluation of the sunrise views demonstrated a medial avulsion fracture of the patella with hinging of the patella on the lateral trochlear ridge via an acute impacted medial patellar defect (Figures 3-5).
case_images: Close-up modified sunrise (patient unable to bend the knee) radiograph of the left knee showing lateral patellar dislocation with medial patellar impaction defect and avulsion fracture of the medial patella
case_images: cureus-0015-00000033415-i04.jpg
case_images: PMC9897702_01_cureus-0015-00000033415-i04.jpg
case_images: FIG4
case_images: Careful evaluation of the sunrise views demonstrated a medial avulsion fracture of the patella with hinging of the patella on the lateral trochlear ridge via an acute impacted medial patellar defect (Figures 3-5).
case_images: Comparison sunrise radiograph of the right knee showing laterally subluxated patella without congenital anatomic abnormality that may predispose the injured side to locked dislocation
case_images: cureus-0015-00000033415-i05.jpg
case_images: PMC9897702_01_cureus-0015-00000033415-i05.jpg
case_images: FIG5
case_images: Careful evaluation of the sunrise views demonstrated a medial avulsion fracture of the patella with hinging of the patella on the lateral trochlear ridge via an acute impacted medial patellar defect (Figures 3-5).
case_images: Intra-reduction fluoroscopy sunrise radiograph of the left knee confirmed a successfully reduced patella
case_images: cureus-0015-00000033415-i06.jpg
case_images: PMC9897702_01_cureus-0015-00000033415-i06.jpg
case_images: FIG6
case_images: Subsequent post-reduction exam under sedation was improved and displayed a ligamentously stable knee that had regained full mobility; although it displayed lateral tilt, it was found to track within the trochlea with knee flexion under sedation and was confirmed on the intra-sedation sunrise view with mini-c-arm fluoroscopy (Figure 6).
case_images: Post-reduction axial computed tomography image emphasizing the acute impaction defect of the left medial patella
case_images: cureus-0015-00000033415-i07.jpg
case_images: PMC9897702_01_cureus-0015-00000033415-i07.jpg
case_images: FIG7
case_images: Subsequent post-reduction treatment included computed tomography (patient or guardian declined acute MRI for soft tissue evaluation, due to ER wait times), which confirmed reduction, the lack of unrecognized fractures or intra-articular osseous bodies, the lack of previously unrecognized soft tissue injury, and better characterized the previously appreciated medial avulsion fracture and impaction defect of the patella (Figure 7).