Contents
Much like olecranon fractures, the patella is part of the extensor mechanism of the knee. Treatment depends on the integrity of the extensor mechanism and the degree of articular disruption.
Clinical
History
- A fall with sudden quads contraction or a direct blow to the patella.
Physical
- Look for open wounds/abrasions
- Palpate for a gap in the patella, quads or patella tendon.
- Assess straight leg raise – this is an essential test. Even if painful
- Encourage the patient to try as it may make the difference between
- Operative and non-operative Rx.
Xray
- Exclude a bipartite patella!!
- Measure any articular step or gap.
- Look for other fractures or loose bodies within the joint.
Treatment
Intact extensor mechanism/ < 2mm step or gap.
- Jones + Crutches.
- Early ROM + Wt Bearing.
Unable to SLR/2mm or more step or gap/open fracture
- Admit for ORIF.
