Surgical Management of Patellar Fractures
Rafael Kakazu1, Michael T Archdeacon1
1Department of Orthopaedic Surgery, University of Cincinnati Academic Health Center, PO Box 670212, Cincinnati, OH 45267-0212, USA.
Abstract:
The patella plays a crucial role in the extensor mechanism to increase the mechanical advantage of the quadriceps. Fractures can be classified based on displacement, comminution, and fracture pattern, which often guide treatment. Modern treatment options include internal fixation using tension bands with Kirschner wires or cannulated screws, lag screw fixation, partial patellectomy, and rarely total patellectomy. Nondisplaced, closed patellar fractures or fractures with less than 2-mm articular steps can be successfully treated conservatively. Open fractures, articular step of 2 mm or greater, and loss of knee extension are indications for surgical intervention.
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