Executive Editor: Chris Colton

Authors: Florian Gebhard, Phil Kregor, Chris Oliver

Patella

back to skeleton

Glossary

Surgical procedures sorted by fracture type

Use this menu to jump directly into a specific classification (optional):
A1 A2 B1.1 B1.2 B2.1 B2.2 C1.1/2 C1.3 C2 C3.1 C3.2
A1

Extraarticular avulsion fracture

Please select a treatment option:
Treatment Indication summary Skill Equipment
Open reduction; salvage techniques Distal fragment too fragmented to repair Highly experienced and skilled surgeon Simple surgical and imaging resources
Open reduction; sleeve fracture fixation Sleeve fracture with impaired extensor function Some specialized surgical experience Simple surgical and imaging resources
Open reduction; Krackow whip stitch - suture repair Distraction with impaired extensor function Some specialized surgical experience Simple surgical and imaging resources
A2

Extraarticular isolated body fracture

Please select a treatment option:
Treatment Indication summary Skill Equipment
Long leg cast then hinged knee brace All A2 fractures Basic surgical experience, no specialized skills Basic equipment only
B1.1

Partial articular fractures, vertical, lateral; simple

Please select a treatment option:
Treatment Indication summary Skill Equipment
Long leg cast then hinged knee brace Undisplaced fractures Basic surgical experience, no specialized skills Basic equipment only
Open reduction; lag screws Displaced fractures Some specialized surgical experience Simple surgical and imaging resources
B1.2

Partial articular fractures, vertical, lateral; comminuted

Please select a treatment option:
Treatment Indication summary Skill Equipment
Long leg cast then hinged knee brace Undisplaced fractures Basic surgical experience, no specialized skills Basic equipment only
Open reduction; lag screws Displaced fractures; surgeon's preference Highly experienced and skilled surgeon Simple surgical and imaging resources
Open reduction; cerclage wire Displaced fractures; surgeon's preference Highly experienced and skilled surgeon Simple surgical and imaging resources
B2.1

Partial articular fractures, vertical, medial; noncomminuted

Please select a treatment option:
Treatment Indication summary Skill Equipment
Long leg cast then hinged knee brace Undisplaced fractures Basic surgical experience, no specialized skills Basic equipment only
Open reduction; lag screws Articular displacement, lateral instability of the patella Highly experienced and skilled surgeon Simple surgical and imaging resources
B2.2

Partial articular fractures, vertical, medial; comminuted

Please select a treatment option:
Treatment Indication summary Skill Equipment
Long leg cast then hinged knee brace Undisplaced fractures Basic surgical experience, no specialized skills Basic equipment only
Open reduction; cerclage wire Lateral instability of the patella; surgeon's preference Some specialized surgical experience Simple surgical and imaging resources
Open reduction; lag screws Lateral instability of the patella; surgeon's preference Highly experienced and skilled surgeon Simple surgical and imaging resources
C1.1/2

Complete articular fractures, transverse; middle and proximal

Please select a treatment option:
Treatment Indication summary Skill Equipment
Open reduction; tension band wiring All C1.1/2 displaced fractures Some specialized surgical experience Simple surgical and imaging resources
C1.3

Complete articular fractures, transverse; distal

Please select a treatment option:
Treatment Indication summary Skill Equipment
Open reduction; tension band wiring Distraction with impaired extensor function Some specialized surgical experience Simple surgical and imaging resources
Open reduction; salvage techniques Distal fragment too fragmented to repair Highly experienced and skilled surgeon Simple surgical and imaging resources
Open reduction; Krackow whip stitch - suture repair Distraction with impaired extensor function Some specialized surgical experience Simple surgical and imaging resources
C2

Complete articular transverse fractures plus additional fragment

Please select a treatment option:
Treatment Indication summary Skill Equipment
Open reduction; cerclage wire Joint surface reconstructable Highly experienced and skilled surgeon Simple surgical and imaging resources
Open reduction; salvage techniques Split fragment cannot be repaired Highly experienced and skilled surgeon Simple surgical and imaging resources
C3.1

Complete articular fractures, complex; with 4 fragments

Please select a treatment option:
Treatment Indication summary Skill Equipment
Open reduction; cerclage wire Joint surface reconstructable Highly experienced and skilled surgeon Simple surgical and imaging resources
Open reduction; salvage techniques Patella too fragmented to reconstruct Highly experienced and skilled surgeon Simple surgical and imaging resources
C3.2

Complete articular fractures, complex; with more than 4 fragments

Please select a treatment option:
Treatment Indication summary Skill Equipment
Open reduction; cerclage wire Joint surface reconstructable Highly experienced and skilled surgeon Simple surgical and imaging resources
Open reduction; salvage techniques Patella too fragmented to reconstruct Highly experienced and skilled surgeon Simple surgical and imaging resources

Special considerations

Principles of management of open fractures
Infection
*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

v1.0 2008-12-03