Fracture of the patella Cont Fig Anatomy Largest
- Slides: 20
Fracture of the patella
Cont. . • Fig
Anatomy • Largest sesamoid bone in the body. • Quadriceps tendon inserted on the superior pole and the patellar ligament originates from the inferior pole. • Funtion of the patella is to increase the mechanical advantage and protection.
Cont. . • Fig
Mechanism of injury • • Direct trauma : Due to direct fall over the patella Usually cause comminuted fractures and are the common causes Indirect trauma (quadriceps contraction ): Sudden forceful contraction of the quadriceps (as in sports ) Age : common in 20 – 50 years age group
Clinical evaluation • Patient usually non ambulatory. • Pain, swelling • Abrasion over the patella. • Unable to extend the knee • Both the active and passive movements are restricted
On examination • • Palpable gap Tenderness signs of effusion Positive patellar
Classification Undisplaced • Transverse fracture (80%) • Vertical fracture • Comminuted fracture Displaced Transverse (85 %) • Oblique fracture • Vertical fracture • Comminuted fracture osteochondral fracture
Classification • Fig
Investigation X – ray : • AP view • lateral view • Skyline view • CT scan • Bone scan • MRI
Lateral view • Fig :
Skyline view • Fig
Tests : • Patellar tap • Fluctuation test
Patellar tapping • Fig :
Treatment • Non operative – For non displaced fracture – Cylinder cast: extending from the groin to just above the malleoli for 4 to 6 weeks. – Followed by physiotherapy- quadriceps strengthening exercise.
Operative • Tension band wiring. (figure of 8) • Patellectomy – Partial: for proximal pole fracture; major fragment is preserved; . – Complete: for comminuted fractures. – Knee should be immobilized for 3 to 6 weeks in a long leg cast at 10 degrees flexion for both partial and complete patellectomy.
Patella Knee Support • Fig
Cont. . • Open reduction and internal fixation for transverse fracture
Complications • • • Refracture Non union Avascular necrosis of fragments Osteoarthritis Knee stiffness Patellar instability
- Debriefing report
- Cont or cont'd
- Fig. 2
- Patella fracture mechanism of injury
- Ductile failure vs brittle failure
- Angle trochléen normal
- Hemarthrosis
- Medial articular facet of patella
- Knee lateral joint line
- Posterior side of humerus
- Fleksi ekstensi
- Classification de duparc patella
- Malleolus medialis
- Sltpttch
- Fracture en etoile de la rotule
- Bursa infrapatellaris
- Leğen kemiği
- Anatomie patella
- Embrochage haubanage rotule
- Anslag af patella
- Settegast method patella