A series of 64 comminuted displaced fractures of the patella is reviewed. Morphologically the fractures can be classified into three groups reflecting the mechanism of injury and the degree of soft tissue damage. All fractures were operated on. Tension band wire was used in 21, partial patellectomy in 33 and total patellectomy in 10 patients. The problem of the management of these fractures is often in making the choice between excision and internal fixation. In this retrospective analysis the results of anterior tension band wire fixation were acceptable even in severe comminuted fractures. Partial excision showed satisfactory results provided that at least three-fifths of the patella could be preserved. Total excision is sometimes clearly unavoidable but should be preceded by sober contemplation whenever considered as the alternative to internal fixation.

Comminuted displaced fractures of the patella

The tension band principle was applied in the operative treatment of fractures of the patella in 139 patients, of which 100 were reviewed retrospectively; 61 per cent were males and 70 per cent were aged between 50 and 70. The fractures were treated soon after admission and movement of the knee was started as soon as possible after the operation. Sixty-eight patients were reviewed and 72 per cent were happy with the resulting knee function. Objectively, 81.3 per cent had an excellent or good result. Minor troubles from the operations were common but it was concluded that the wiring of fractured patellas using the tension band principle is a safe and effective technique.

Fractured patella: operative treatment using the tension band principle.

Patellar fracture is a common injury caused by excessive tension through the extensor mechanism or a direct blow. The intact patella increases the leverage and efficiency of the extensor mechanism and articulates with the femoral trochlea. Patellar fractures can lead to stiffness, extension weakness, and patellofemoral arthritis. Nonsurgical management is indicated for nondisplaced fractures with an intact extensor mechanism. Surgical fixation is recommended for fractures that either disrupt the extensor mechanism or demonstrate >2 to 3 mm step-off and >1 to 4 mm of displacement. Anatomic reduction and fixation with a tension-band technique is associated with the best outcomes; however, symptomatic hardware is a frequent complication. Open fractures are associated with more complications than closed fractures. These complications can be mitigated with timely debridement, irrigation, and internal fixation.

Patellar Fractures in Adults

Fractures of the Lower Extremity

Objectives:To evaluate the midterm functional outcomes of patients with isolated operatively treated patella fractures.Design:Prospective cohort and retrospective clinical and radiographic assessment.Setting:A Level I and Level II trauma center.Patients/Participants:Two hundred forty-one patients un

Functional outcomes after operatively treated patella fractures.

(1972). Fracture of the Patella: A Study of 422 Patellar Fractures. Acta Orthopaedica Scandinavica: Vol. 43, No. sup143, pp. 1-80.

https://www.tandfonline.com/doi/pdf/10.3109/ort.1972.43.suppl-143.01

Åke Boström

Papers

Fracture of the patella. A study of 422 patellar fractures.