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J Knee Surg 2013; 26(05): 293-300
DOI: 10.1055/s-0033-1353988
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Displaced Patella Fractures

Gregory J. Della Rocca
1   Department of Orthopedic Surgery, University of Missouri, Columbia, Missouri
› Author Affiliations
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Publication History

01 July 2013

08 July 2013

Publication Date:
21 August 2013 (online)

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Abstract

Displaced patella fractures often result in disruption of the extensor mechanism of the knee. An intact extensor mechanism is a requirement for unassisted gait. Therefore, operative treatment of the displaced patella fracture is generally recommended. The evaluation of the patella fracture patient includes examination of extensor mechanism integrity. Operative management of patella fractures normally includes open reduction with internal fixation, although partial patellectomy is occasionally performed, with advancement of quadriceps tendon or patellar ligament to the fracture bed. Open reduction with internal fixation has historically been performed utilizing anterior tension band wiring, although comminution of the fracture occasionally makes this fixation construct inadequate. Supplementation or replacement of the tension band wire construct with interfragmentary screws, cerclage wire or suture, and/or plate-and-screw constructs may add to the stability of the fixation construct. Arthrosis of the patellofemoral joint is very common after healing of patella fractures, and substantial functional deficits may persist long after fracture healing has occurred.

Keywords

patella fracture - patellectomy - fracture fixation
 

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