A Clinical Study of the Comminuted Fracture of Patella

Choi, Il Yong; Kim, Sung Joon; Kim, Tai Seung; Lee, In Mool

Abstract

Recently the fracture of patella especially comminuted fracture has increasing tendency due to frequent traffic accident. Because of the patella is an important functional component of the knee extensor mechanism, and proximal three-quarters of the posterior surface of the patella are covered with articular cartilage. accurate reduction and rigid fixation are important in treatment of the comminuted fracture of the patella. Some fractures were treated successfully by immobilization in a cylinder or an above-knee cast, but most patellar fractures should be treated surgically. Various techniques of internal fixation have been recommended for comminuted fractures of the patella, but best way should be selected out of various methiods case by case. In this series, 48 comminuted patella fractures between January, 1990 and April, 1995 have been reviewed at least 9 months after injury and obtained following results. 1. Peak age was third to fifth decade and predominant in men. 2. The major causes of the comminuted patella fractures were traffic accident in over-all, and slip down in sixth and seventh decades. 3. Most fractures were accompainied by other fractures. 4. fourteen patients had postoperative complications, six had patellofemoral osteoarthritis, three metal failure, two loss of reduction, two superficial infections and one malunion. 5. In long-term follow up, the factors that related to the range of motion of the affected knee were though to not the operative method but initial severity of the comminution and accampanied injury.