Annual Report

Executive Editor: Rick Buckley, Chris Colton

Authors: Florian Gebhard, Phil Kregor, Chris Oliver

Patella Partial articular, medial sagittal fragmentary fracture

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Glossary

1 Principles top

The patello-femoral joint is biomechanically very stressed when the knee is loaded. Any compromise of the joint surface is likely to lead to degenerative joint disease. It is, therefore, highly desirable, in patellar fractures to strive for anatomical reduction of the joint surface and stable fixation.

An additional treatment goal is restoration of function of the knee extensor mechanism and allow early range of motion of the knee.

2 Patient preparation and approach top

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Patient preparation

This procedure is normally performed with the patient in a supine position with the knee flexed 30°.


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Approach

For this procedure a mid-axial longitudinal approach is used.

3 Reduction and fixation top

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Debridement

The knee joint and fracture lines must be irrigated and cleared of blood clot and small debris to allow exact reconstruction.


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Reduction

The larger fragments are reduced using a pointed reduction forceps or tenaculum.

Sagittal fractures are more easily reduced with the knee flexed.

Reduction is held by one or two reduction forceps.


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Verify the reduction by palpation of the retropatellar surface.


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Temporary fixation

Two K-wires are inserted through the planned screw trajectory with the fracture reduced


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Fixation

Drill holes are made over the K-wires.


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The suture anchor is inserted with a stitch coming out the hole.


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When these anchors are used in pairs, the stitch is tied to its partner to ensure good fixation.

v2.0 2019-03-21