Patella Fractures

Question 1

What are the non-operative indications for management of patella fractures?

Answer 1

1) minimally displaced
2) retinacula intact (can straight leg raise)
3) vertical fractures

Knee immobilizer or cylinder cast with WBAT; begin flexion at 2-3 weeks

Question 2

What are the operative indications for patella fractures?

Answer 2

1) Retinacula disrupted (cannot straight leg raise)
2) >2mm articular step-off
3) >3mm displacement
4) open injury
5) patellar sleeve fractures in children

Question 3

What are fixation options for ORIF of patella fractures?

Answer 3

1) Tension band with 0.062 k-wires
2) tension band with cannulated screws
3) interfragmentary screws with cerclage wiring
4) low profile tension plating

Question 4

When should a partial patellectomy be performed?

Answer 4

Severely comminuted inferior pole fractures with

Question 5

What is the most common complication following ORIF of patella fractures?

Answer 5

Symptomatic hardware;

~20% require removal