5. ïĄA : can talk, no C-spine tenderness
ïĄB : equal breath sound both lungs, CCT neg
ïĄC : BP 146/60 PR 74, no active bleed
ïĄD : E4V5M6, pupil 3 mmRTLBE
ïĄE : mark swelling , tender at Lt knee, no
ecchymosis , no external wound, no bleeding, limit
ROM due to pain
PRIMARY SURVEY
7. ïĄVital sign : BP 146/60 mmHg, PR 74/min
RR 16/min, T 36.9 C
ïĄGA : A Thai woman,Good consciousness
ïĄHEENT : No pale conjunctivae ,anicteric sclera
ïĄCVS : Normal S1S2 , no murmur
ïĄRS : Equal breath sound, no adventitious sound
ïĄGI : soft ,not tender , liver & spleen not palpable
ïĄCNS : Motor gr. V all
PHYSICAL EXAMINATION
8. ïĄExt :
ïĄLt knee : mark swelling, no deformity, no ecchymosis
, no external wound, no bleeding, tender at Lt knee,
limit ROM due to pain (active, passive) ,DPA 2+ ,PTA
2+
ïĄLt Hip and ankle : not tender, full ROM
PHYSICAL EXAMINATION
12. ïĄ1. Undisplaced āđāđāđāđāđāđāđ indirect force āđāđāđ
retinacular ligament āđāđāđāđāđāđ
ïĄ2. Transverse āđāđāđāđāđāđāđ indirect force āđāđāđ
retinacular ligament āđāđāđ āđāđāđāđāđāđāđāđāđāđāđāđāđ
āđāđāđāđāđāđāđāđāđāđāđāđāđ patella fractures
ïĄ3. Lower or upper pole āđāđāđāđāđāđāđ indirect force
āđāđāđāđāđāđāđ
ïĄ4. Comminuted āđāđāđāđāđāđāđ direct force āđāđāđāđ
combined forces
ïĄ5. Vertical āđāđāđāđāđāđāđāđāđāđ lateral facet āđāđāđ direct
injury
CLASSIFICATION
13. ïĄPalpable patella defect
ïĄSignificant hemarthrosis
ïĄUnable to perform straight leg raise (failure of
extensor mechanism)
ïĄtenderness and swelling around fracture site
ïĄRetinaculum disrupted
SIGN AND SYMPTOM
20. ïĄPatellectomy
ïĄPartial : comminuted superior or inferior pole
fracture measuring <50% patellar height ONLY if
ORIF is not possibleÂ
ïĄTotal : reserved for severe and extensive
comminution
OPERATIVE TREATMENT
21. ïĄLate osteoarthritic change of
patellofemoral joint
ïĄāļāļāļāļāļāļāļāļāļāļ āļāļāļāļāļāļ fracture site āļāļ
displacement āļāļāļāļ stepoff āļāļāļ āļāļāļāļāļāļāļāļāļ
āļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļ
āļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļ
āļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļāļ
āļāļāļāļāļ āļāļāļāļāļāļāļ early degenerative change
COMPLICATION