Executive Editor: Rick Buckley, Chris Colton

Authors: Florian Gebhard, Phil Kregor, Chris Oliver

Patella Partial articular, medial sagittal fragmentary fracture - Anchor stitches

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Glossary

Aftercare following suture anchor fixation

Introduction

Active knee function requires an intact knee extensor mechanism, a mobile patella, a well-preserved patello-femoral joint and muscle strength.

As suture anchors are only used in sagittal patellar fractures, and this fracture has now been stabelized with the anchor, the knee may be moved freely without protection postoperatively.

Early controlled range of motion exercises are combined with static quadriceps strengthening exercises. The progressive increase in loading of the patello-femoral joint depends on many factors and requires planned individual programs, designed by the surgeon and physical therapists.

Functional treatment

Patellar fixation is generally quite stable. Early progressive, active mobilization is beneficial after surgery. Static isometric quadriceps exercises should be started on postoperative day 1.

Afterwards, special emphasis should be given on active knee and hip movement.

Weight bearing

A removable knee splint is applied and worn until skin healing at 2 weeks and good quadriceps control is regained. Full weight bearing may be performed with a straight knee, using crutches or a walker, from postoperative day 1.

Follow-up

X-rays should be taken at 2, 6 and 12 weeks. A longer period may be required if fracture healing is delayed.

v2.0 2019-03-21