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Fracture, Patella, Sports Medicine

Aaron J. Provance, MD, FAAP, CAQSM Reviewed 04/2019
 


BASICS

Mechanisms of injury: 
  • Direct trauma: often comminuted but minimally displaced; associated with fractures of the tibia, femur, and hip as well as posterior hip dislocation

  • Indirect trauma: exerti...

DIAGNOSIS

  • Transverse (50–80%): Usually displaced, of the middle and lower thirds in the adult population, most patellar fractures sustained during sports participation are of the transverse type 1[C]....

TREATMENT

  • Acute management:

    • Analgesia

    • Aspiration of hemarthrosis may be followed by injection of local anesthesia to facilitate assessment of the extensor mechanism. Presence of fatty globules is indica...

ONGOING CARE

  • Immobilization: long leg cast for nonoperative treatment and for 3 to 6 wk after partial or total patellectomy; immediate joint motion if intraoperative fracture stability is achieved 1[C...

REFERENCES

1
Bharam S, Vrahas MS, Fu FH. Knee fractures in the athlete. Orthop Clin North Am.  2002;33(3):565–574.
2
Dupuis CS, Westra SJ, Makris J, et al. Injuries and conditions of the extensor me...

ADDITIONAL READING

Safran M, Zachazewski JE, Stone DA, (eds). Patellar fracture. In: Instructions for Sports Medicine Patients. 2nd ed. Philadelphia, PA: Elsevier; 2012:755–760. 

CLINICAL PEARLS

  • Most athletes with patellar fractures return to play the following season (3 to 6 mo) with little residual deficit. Return of function is more limited with comminuted, high-impact mech...

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