Fracture of the patella is a common injury comprising approximately 1% of all fractures. They are most often caused by a direct blow to the flexed knee, or trauma to the front of the knee. Typical clinical signs include swelling, tenderness and an inability to straight raise the knee against gravity. The quadriceps produces significant forces on patellar fractures that can cause early fixation failure. For this reason, screw fixation alone usually fails. In addition to fracture stability, tension band wiring for fracture of the patella can allow an advantageous early range of motion of the knee. The tension band lies on the anterior surface of the patella, and works by converting tensile forces into compression forces at the fracture line.
The patient is placed supine on a standard operating table. A tourniquet is placed on the ipsilateral side as the injury. The image intensifier should be placed on the contralateral side to the injury with adequate space to move in and take X-rays. The display unit is placed at the foot of the bed. The surgeon stands on the ipsilateral side to the injury.
Complications
• Scarring.
• Pain.
• Infection.
• Protruding or irritating metalware.
• Malunion.
• Non-union.
• Osteoarthrosis (long term).