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Patellar fractures in elderly patients: a multicenter computed tomography-based analysis.

Jae-Ang Sim1, Yong Bum Joo2, Wonchul Choi3

  • 1Department of Orthopaedic Surgery, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.

Archives of Orthopaedic and Trauma Surgery
|July 26, 2020
PubMed
Summary

Elderly patellar fractures are often low-energy, with common types C3 and A1. These fractures show high rates of inferior pole involvement and comminution, leading to significant complication and reoperation rates.

Keywords:
CTFractureFragility fractureOutcomePatella

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Area of Science:

  • Orthopedic Surgery
  • Geriatric Trauma
  • Fracture Management

Background:

  • Patellar fractures are common injuries.
  • Elderly patients present unique challenges in fracture management.
  • Understanding fracture characteristics and outcomes in this demographic is crucial.

Purpose of the Study:

  • To characterize patellar fractures in patients aged 60 years and older.
  • To evaluate the clinical outcomes of these fractures.
  • To compare outcomes based on injury mechanism (low-energy vs. high-energy).

Main Methods:

  • Retrospective review of 202 patients (≥60 years) with patellar fractures from a multicenter orthopedic database.
  • Analysis of patient demographics, fracture patterns (AO/OTA classification, CT findings), and injury mechanisms.
  • Evaluation of surgical treatment, union time, range of motion, functional scores (Lysholm), complications, and reoperation rates.

Main Results:

  • Most fractures (75%) resulted from low-energy injuries.
  • AO/OTA type C (67.3%) was most common, with frequent inferior pole involvement (66.8%) and comminution (80.7%) on CT.
  • Surgical treatment was common (82.2%), with a mean union time of 13.1 weeks and a Lysholm score of 82.1.
  • Complication rate was 12.4%, and the reoperation rate was 26.4%.

Conclusions:

  • Patellar fractures in the elderly are predominantly low-energy injuries, often comminuted with inferior pole involvement.
  • Clinical outcomes show moderate functional recovery but are associated with high complication and reoperation rates.
  • These findings highlight the need for careful management strategies in geriatric patellar fracture patients.