Mapping of Patellar Fracture Patterns: A Multicenter Study of 237 Patients

Background/Objectives: Patellar fractures are rare but clinically significant due to their impact on knee function. These injuries vary from simple transverse to complex comminuted patterns. Computed tomography (CT) offers superior visualization compared to radiographs, enabling accurate classification and surgical planning. This study utilized CT-based fracture mapping to analyze fracture patterns and evaluate the impact of age, trauma-center level, and AO/OTA classification. Methods: This retrospective study included 237 patients diagnosed with patellar fractures who underwent CT imaging. Fractures were classified using the AO/OTA system, and fracture mapping was performed by overlaying fracture lines onto a standardized template. Statistical analysis assessed correlations between patient demographics, trauma-center level, and fracture patterns. Results: The cohort comprised 107 males and 130 females with a mean age of 56.9 ± 20.9 years. Males were significantly younger than females (49.2 vs. 63.3 years, p < 0.001). Fractures were evenly distributed between the right (46%) and left (54%) patellae. Type C fractures were the most common (54.4%), followed by Type B (29.9%) and Type A (15.6%). Trauma-center level was inversely associated with fracture severity (p < 0.001), with complex fractures more common at lower-level centers. Age was positively correlated with fracture severity (p = 0.001). Fracture mapping revealed the central patella as the most frequently affected region, with transverse fractures extending medially and laterally, sparing the upper and lower poles. Conclusions: CT imaging enhances the classification and mapping of patellar fractures, highlighting the central patella as the primary site of injury. Fracture severity correlates with age and trauma-center level. These findings support CT-based mapping as a valuable tool for improving surgical planning and treatment outcomes.