Isolated bilateral patella fracture in an unusual context: a case report of a 23-year-old patient after a physical assault

Bilateral patella fractures, mostly caused by road accidents, are infrequent skeletal injuries and are rarely reported. We report a rare case of bilateral patella fracture occurring in an unusual context: in a healthy 23-year-old man with no comorbid conditions who was the victim of a physical assault. He was brought to the emergency room for bilateral knee pains and inability to bear weight on both lower limbs. He complained of feeling pain in several parts of his body but predominantly on his knees. Clinical examination revealed swollen knees with abrasions over the left knee and on the anterior aspect of both legs (A), and an inability to actively extend both knees. Distal neurovascular examination of lower limbs was normal. X-rays of both knees showed transversal fractures of both patellae (B). Internal fixation methods treated both knees (C). For the right knee, after a partial patellectomy of the distal fragment, the extensor mechanism was repaired and strengthened with a cerclage. A tension band technique was used for the left knee. Post-operatively, the patient was discharged on oral analgesics with both knees being kept in full extension with hinged knee immobilizers (D). Early weight-bearing supported by two crutches was authorized, and a ten-week continuous rehabilitation program of gradual knee movements was prescribed. Full weight-bearing without support was regained at ten weeks. At the last follow-up of one year, he had normal muscle strength with no limitation in routine activities and did not report knee pains or symptoms of patella instability.