Treatment of Patella Fractures.

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Abstract

[Indexed for MEDLINE] 6. Oper Orthop Traumatol. 2009 Jun;21(2):206-20. doi: 10.1007/s00064-009-1708-5. [Patella fracture]. [Article in German] Dietz SO(1), Hessmann MH, Gercek E, Rommens PM. Author information: (1)Klinik und Poliklinik für Unfallchirurgie, Klinikum der Johannes Gutenberg-Universität Mainz, Langenbeckstrasse 1, 55101, Mainz, Germany. dietz@unfall.klinik.uni-mainz.de OBJECTIVE: Reconstruction of the extensor apparatus of the knee joint. Open reduction and stable internal fixation of patella fractures. Exact reconstruction of the articular surface of the patellofemoral joint. INDICATIONS: Open and closed fractures. Fractures with an intraarticular incongruity (> 2 mm). Incapability of extension of the knee also in nondisplaced fractures of the patella. In the context of internal fixations of additional periarticular fractures of the knee joint. CONTRAINDICATIONS: Compromised general health status or associated injuries. Compromised local soft-tissue situation (contamination, poor soft-tissue cover). Relative: nondisplaced transverse fractures (no displacement in 40 degrees of flexion). Relative: nondisplaced longitudinal fractures(3). Relative: nondisplaced radiating fractures(3). Relative: nondisplaced fractures of the distal pole without involvement of the joint surface and intact extensor apparatus(3). SURGICAL TECHNIQUE: Longitudinal parapatellar incision. Tension band wiring. Lag screw osteosynthesis. Combination of tension band wiring and lag screws. Patellectomy (partial/complete). POSTOPERATIVE MANAGEMENT: Thrombosis prophylaxis. Early physiotherapy. Knee brace. RESULTS: 70% good to excellent results. 30% chronic pain and posttraumatic arthritis. Loss of motion (limited extension). DOI: 10.1007/s00064-009-1708-5