Patella fracture

Abstract

The patella is the largest and biomechanically most important sesamoid bone of the human body. It is located on the anterior portion of the knee with attached quadriceps and patellar tendons. Due to its location, the patella can easily traumatize because of direct contact or impact on the knee. In the literature, the patella fracture prevalence is reported as about 1% of all bone fractures. On the physical examination, the physician may detect knee pain, a gap on the patella, swelling, ecchymosis, and knee joint limitation resulting from the extensor mechanism injury. After physical and radiological examination, the physician should decide the form of treatment. The indication for conservative treatment is an interfragmental gap of less than 3 mm and articular stepping of less than 2 mm. Conservative treatments, including cast or splint implementation and immobilizer or brace usage, can be chosen according to the patient’s medical condition. If surgery is needed, the technique chosen for the surgical treatment depends on the surgeon’s preference and experience. After conservative treatment, rehabilitation of the knee can begin when the bone healing is approved with an x-ray. Additionally, after surgical treatment, physical rehabilitation can begin with quadriceps isometric exercises on postoperative day one and can continue for up to 6 months with some rehabilitation modalities to improve the range of motion and strength for preventing stiffness and weakness. Despite appropriate treatment and intensive physical therapy, complications may develop in the knee. Possible complications include infection, stiffness, weakness, implant failure, arthritis, nonunion, delayed wound healing, reduction loss, etc. A complication may also occur in experienced hands, but a specialist knows how to manage and solve it. However, it has been shown in the literature that the success of treatment after patella fractures is high, and the complication rates are low.