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April 12, 1924


Author Affiliations

Bluefield, W. Va.

JAMA. 1924;82(15):1198-1199. doi:10.1001/jama.1924.26520410005015d

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These two cases occurred within thirty days. Both were injuries to boys, aged 15 years. The literature at my disposal does not cite a similar case, and the surgical aspects were almost identical in the two cases.

Case 1.  —J. L. jumped on a freight train in motion, to steal a ride. With one foot in the stirrup, and the other hanging down, his knee struck against a switch light. This knocked him off, throwing him 10 or 12 feet, when the same knee struck against the end of a railroad tie. Roentgen-ray examination (Fig. 1) revealed a dislocated patella, the superior margin being driven horizontally backward and into the joint, acting as a wedge between the femur and the tibia. The quadriceps extensor tendon was probably ruptured on the first impact, the prepatellar tendon remaining intact, while the second compact with the tie drove the patella into the joint.

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