Management of severely comminuted fracture patella: a case report

Authors

  • Jayant Kumar Department of Orthopaedics, Tata Main Hospital, Manipal Tata Medical College, Jamshedpur, Jharkhand, India
  • Abhay H. Kerketta Department of Orthopaedics, Tata Main Hospital, Manipal Tata Medical College, Jamshedpur, Jharkhand, India
  • Kumar Rahul Department of Orthopaedics, Tata Main Hospital, Manipal Tata Medical College, Jamshedpur, Jharkhand, India
  • Nishant Kumar Niraj Department of Orthopaedics, Tata Main Hospital, Manipal Tata Medical College, Jamshedpur, Jharkhand, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20232006

Keywords:

Patella, Comminuted, Early rehabilitation

Abstract

Fracture patella is a breach in the extensor mechanism of the knee and needs to be fixed. Comminuted fractures of patella are a challenge given the difficulty in restoring the extensor mechanism. Introduction: Treatment options have evolved over the years from sacrifice to salvage i.e., from total or partial patellectomy to patellar preserving surgery. The challenge remains to fix the fragments optimally and also to have a tailor-made physiotherapy and rehabilitation program for the patient to provide a satisfactory functional outcome. A 14-year-old female presented to the casualty with a history of domestic fall, injuring her right knee. X-ray was done which revealed a comminuted fracture of right patella, classified as 34C3 OA/OTA classification. Salvage procedure for severely comminuted patella fracture has a successful functional outcome following a stable fixation of fragment.

References

Neumann HS, Winckler S, Strobel M. Long-term results of surgical management of patellar fractures. Unfallchirurg. 1993;96(6):305-10.

Massoud EIE. Fractured patella in children: Preservation of the patellar dimensions. Dicle Med J. 2012;39:467-73.

Shabat S, Mann G, Kish B, Stern A, Sagiv P, Nyska M. Functionalresults after patellar fractures in elderly patients. Arch Geronto Geriatr. 2003;37(1):93-8.

Kastelec M, Veselko M. Inferior patellar pole avulsion fractures: osteosynthesis compared with pole resection. J Bone Joint Surg Am. 2004;86-A(4):696-701.

Lorich DG, Warner SJ, Schottel PC, Shaffer AD, Lazaro LE, Helfet DL. Multiplanar fixation for patella fractures using a low-profile mesh plate. J Orthop Trauma. 2015;29(12):504-10.

Taylor BC, Mehta S, Castaneda J, French BG, Blanchard C. Platingof patella fractures: techniques and outcomes. J OrthopTrauma. 2014;28(9):e231-5.

Kadar A, Sherman H, Drexler M. Anchor suture fixationof distal pole fractures of patella: twenty seven cases an comparison to partial patellectomy. Int Orthop. 2016;40(1):149-54.

Zhu W, Xie K, Li X. Combination of a miniplate with tension band wiring for inferior patellar pole avulsion fractures. Injury. 2020;51(3):764-8.

Nikiforidis P, Babis G, Tsarouchas J, Koudis G, Korres DS. Patellar fractures: contemporary approach to operative treatment, using different types of the tension band principles. Eur J Orthop Surg Traumatol. 1999;9:21-6.

Boström A. Fracture of the patella. A study of 422 patellar fractures. Acta Orthop Scand Suppl. 1972;143:1-80

Boström A. Longitudinal fractures of the patella. Reconstr Surg Traumatol. 1974;14(0):136-46.

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Published

2023-06-29

Issue

Section

Case Reports