Executive Editor: Rick Buckley, Chris Colton

Authors: Florian Gebhard, Phil Kregor, Chris Oliver

Patella Partial articular, medial sagittal simple fracture

back to skeleton

Glossary

General considerations

These fractures may have implications for instability of the patella. Any significant displacement requires surgical fixation.

The choice between surgical techniques is based on surgeon's experience and preference.

Undisplaced sagittal fractures of the patella are usually stable, do not inhibit extensor function and can be treated nonoperatively.

Bracing
Indication summary Skill Equipment
Undisplaced fractures Basic surgical experience, no specialized skills Basic equipment only

Undisplaced sagittal fractures of the patella are usually stable, do not inhibit extensor function and can be treated nonoperatively.

Indications

  • Preserved extensor function
  • Local soft-tissue compromise

Contraindications

  • Impairment of extensor function
  • Lateral instability of the patella
  • Displacement of the articular surface
Suture anchors
Indication summary Skill Equipment
Displaced fractures; surgeon's preference Highly experienced and skilled surgeon Simple surgical and imaging resources

Anchor stitches may be used alone, or in combination with cerclage wiring

Indications

  • Displaced fractures
  • Inability to actively extend the knee

Contraindications

  • Polytrauma patient in extremis
  • Medically unfit for surgery
  • Local soft-tissue compromise
  • Severe osteoporosis

Advantages

  • Restoration of articular surface
  • Early mobilization of knee joint
  • No prolonged splintage

Disadvantages

  • Possible prominent metalwork after fixation
  • Risks of open operation
Lag screws
Indication summary Skill Equipment
Articular displacement, lateral instability of the patella Highly experienced and skilled surgeon Simple surgical and imaging resources

Lag screw fixation may be used alone, or in combination with cerclage wiring, at the discretion of the surgeon.

Contraindications

  • Polytrauma patient in extremis
  • Medically unfit for surgery
  • Local soft-tissue compromise
  • Severe osteoporosis

Advantages

  • Restoration of articular surface
  • Early mobilization of knee joint
  • No prolonged splintage

Disadvantages

  • Prominent metalwork after fixation
  • Risks of open operation
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

v2.0 2019-03-21