Patella Fracture

PATELLA FRACTURE
Classification
Undisplaced : Stellate, Transverse, Vertical/Longitudinal, Osteochondral
Displaced : Transverse, Stellate, Polar

Mechanism of Injury
Direct fall on patella : stellate or comminuted fractures, usually undisplaced.
Indirect force : Quadriceps forcibly contracts while the knee is flexed, causing transverse or polar fractures.
Exclude bipartite patella.
Examination
Haemarthrosis
Palpable gap in displaced fractures
Test knee extension to determine whether extensor mechanism still intact
X-rays
AP, lateral and skyline views of patella
Management
Undisplaced Closed Fractures with intact extensor mechanism:
Backslab in full knee extension (from proximal-thigh to distal calf)
Analgesics. NWB crutches ambulation
TCU Ortho SOC 1/52
Displaced Fractures/All Open Fractures:
Backslab in full knee extension (from proximal-thigh to distal calf)
Keep NBM
Admit to Ortho Dept for surgery