| Summary: | Purpose: Patellar fractures only account for approximately 1% of all skeletal injuries. Patellar fractures usually result from direct trauma (i.e. falling on the knee, dashboard injury, etc.), or, less frequently, occur as a combination of direct and indirect mechanism (i.e. receiving a direct blow while contracting the quadriceps). While indirect trauma is the least common mechanism, it usually occurs due to an extensor mechanism failure during eccentric loading such as landing. Method: Case report, Level 3: Exploration Clinical Contribution to the Available Sources of Evidence (CASE) Report. Results: A 21-year-old Division I collegiate basketball athlete sustained two separate transverse patellar fractures via non-contact mechanisms in the same knee over a 21-month period. The patient had no prior history of knee injury nor predisposing risk factors for fractures; delayed union or nonunion. Conclusion: The uniqueness of this case is twofold: 1) The rareness of this injury among a healthy athletic population; and 2) The unusual non-contact mechanism of the injury. Patellar injuries are extremely rare in athletics. In NCAA Division I men’s basketball, patellar injury accounts for only 2.4% of all injuries during games and 3.7% during practice. Recommendations: Although rare, it is important for athletic trainers to recognize traumatic high-impact injuries can occur during non-contact activity in a healthy population. In addition, athletic trainers should be mindful to suspect fracture without associated defect when a patient sustains a subsequent injury with an analogous mechanism even following successful rehabilitation.
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