[Patella fracture].
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.


METHODS
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.


METHODS
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).


METHODS
Longitudinal parapatellar incision. Tension band wiring. Lag screw osteosynthesis. Combination of tension band wiring and lag screws. Patellectomy (partial/complete).


METHODS
Thrombosis prophylaxis. Early physiotherapy. Knee brace.


RESULTS
70% good to excellent results. 30% chronic pain and posttraumatic arthritis. Loss of motion (limited extension).
Dietz
Sven-Oliver
SO
Klinik und Poliklinik für Unfallchirurgie, Klinikum der Johannes Gutenberg-Universität Mainz, Langenbeckstrasse 1, 55101, Mainz, Germany. dietz@unfall.klinik.uni-mainz.de
Hessmann
Martin-Henri
MH
Gercek
Erol
E
Rommens
Pol-Maria
PM
D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D010329:Patella / Q000293:injuries* / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome
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