Patellar fractures

Patellar fractures

• Similar to olecranon fractures, undisplaced fractures in which the extensor mechanism is intact can be treated non-operatively . - A simple assessment of this is if the patient can straight leg raise to test the extensor mechanism, but beware of the patient who is able to ‘cheat’ by using the iliotibial band to internally - rotate the leg to compensate for the deficient extensor - mechanism. Displaced fractures require anatomical reduction of the articular surface and reconstitution of the integrity of the extensor mechanism. The cartilage on the patella is very thick; as such, increased amounts of displacement compared with other joints may not lead to degeneration. Surgical treatment of simple displaced fractures can be achieved with two K-wires and figure-of-eight tension band wiring. Multifragmentary patellar fractures can be ver y challeng - ing. Patellar excision is an option but significantly reduces the mechanical advantage of the extensor apparatus. A tension band construct may be augmented by using circumferential wiring of the patella. - n, Patellar fractures

• Similar to olecranon fractures, undisplaced fractures in which the extensor mechanism is intact can be treated non-operatively . - A simple assessment of this is if the patient can straight leg raise to test the extensor mechanism, but beware of the patient who is able to ‘cheat’ by using the iliotibial band to internally - rotate the leg to compensate for the deficient extensor - mechanism. Displaced fractures require anatomical reduction of the articular surface and reconstitution of the integrity of the extensor mechanism. The cartilage on the patella is very thick; as such, increased amounts of displacement compared with other joints may not lead to degeneration. Surgical treatment of simple displaced fractures can be achieved with two K-wires and figure-of-eight tension band wiring. Multifragmentary patellar fractures can be ver y challeng - ing. Patellar excision is an option but significantly reduces the mechanical advantage of the extensor apparatus. A tension band construct may be augmented by using circumferential wiring of the patella. - n, Patellar fractures

• Similar to olecranon fractures, undisplaced fractures in which the extensor mechanism is intact can be treated non-operatively . - A simple assessment of this is if the patient can straight leg raise to test the extensor mechanism, but beware of the patient who is able to ‘cheat’ by using the iliotibial band to internally - rotate the leg to compensate for the deficient extensor - mechanism. Displaced fractures require anatomical reduction of the articular surface and reconstitution of the integrity of the extensor mechanism. The cartilage on the patella is very thick; as such, increased amounts of displacement compared with other joints may not lead to degeneration. Surgical treatment of simple displaced fractures can be achieved with two K-wires and figure-of-eight tension band wiring. Multifragmentary patellar fractures can be ver y challeng - ing. Patellar excision is an option but significantly reduces the mechanical advantage of the extensor apparatus. A tension band construct may be augmented by using circumferential wiring of the patella. - n,