title: Vertical open patella fracture, treatment, rehabilitation and the moment to fixation.
abstract: Patella fracture is relatively uncommon and the vertical trace fracture represents almost 12-17%. The open patella fracture expresses 6-30%. The association of these two uncommon conditions was the aim of this case report even as the treatment and the moment of fixation (definitive surgical treatment). A 27-year-old man after a motorcycle accident showed an open patella fracture classified as a Gustilo and Anderson type IIIA lesion. The patient was immediately treated with precocious surgery fixation with a modified tension band which consists of two parallel K-wires positioned orthogonal to the fracture line and a cerclage wire shaped anteriorly at patella as an eight. The premature fixation benefited the infection prevention and provided earlier joint motion, which increased the nutrition of articular cartilage. Six months postoperatively, the patient had a satisfactory joint motion with full extension and 116° of joint flexion and returned to his daily life activities without restriction. Twelve months postoperatively, the patient had full extension and 120° of knee flexion without pain, joint effusion and instability. Muscle strength force was considered normal at grade V. In conclusion, early chirurgic treatment and precocious articular mobilization improve prognosis, suggesting that the employment of these practices should be adopted whenever possible in most of the open fractures.
authors.affiliation: Servico de Ortopedia e Traumatologia do Hospital Universitario de Santa Maria (SOT - HUSM), Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul (RS), Brazil.
authors.forename: Joao Alberto
authors.initials: JA
authors.lastname: Larangeira
authors.affiliation: Servico de Ortopedia e Traumatologia do Hospital Universitario de Santa Maria (SOT - HUSM), Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul (RS), Brazil.
authors.forename: Liliane
authors.initials: L
authors.lastname: Bellenzier
authors.affiliation: Servico de Ortopedia e Traumatologia do Hospital Universitario de Santa Maria (SOT - HUSM), Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul (RS), Brazil.
authors.forename: Vanessa da Silva
authors.initials: Vda S
authors.lastname: Rigo
authors.affiliation: Servico de Ortopedia e Traumatologia do Hospital Universitario de Santa Maria (SOT - HUSM), Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul (RS), Brazil.
authors.forename: Elias Josue
authors.initials: EJ
authors.lastname: Ramos Neto
authors.affiliation: Servico de Ortopedia e Traumatologia do Hospital Universitario de Santa Maria (SOT - HUSM), Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul (RS), Brazil.
authors.forename: Francisco Fritsch Machry
authors.initials: FF
authors.lastname: Krum
authors.affiliation: Servico de Ortopedia e Traumatologia do Hospital Universitario de Santa Maria (SOT - HUSM), Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul (RS), Brazil ; Departamento de Cirurgia, Centro de Ciencias da Saude (CCS), Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul (RS), Brazil.
authors.forename: Tiango Aguiar
authors.initials: TA
authors.lastname: Ribeiro
keywords: Intra-articular fractures; Open fractures; Patella; Primary wound closure; Tension band