3. Anatomy
• Largest sesamoid bone in the body.
• Quadriceps tendon inserted on the
superior pole and the patellar ligament
originates from the inferior pole.
• Funtion of the patella is to increase the
mechanical advantage and protection.
5. Mechanism of injury
Direct trauma :
• Due to direct fall over the patella
• Usually cause comminuted fractures and
are the common causes
Indirect trauma (quadriceps contraction
):
• Sudden forceful contraction of the
quadriceps (as in sports )
• Age : common in 20 – 50 years age group
6. Clinical evaluation-
• Patient usually non
ambulatory.
• Pain, swelling
• Abrasion over the patella.
• Unable to extend the knee
• Both the active and
passive movements are
restricted
16. Treatment
• Non operative
–For non displaced fracture
–Cylinder cast: extending from the groin
to just above the malleoli for 4 to 6
weeks.
–Followed by physiotherapy- quadriceps
strengthening exercise.
17. Operative-
• Tension band wiring.
(figure of 8)
• Patellectomy
– Partial:for proximal pole fracture;
major fragment is preserved;.
– Complete: for comminuted
fractures.
– Knee should be immobilized for 3
to 6 weeks in a long leg cast at
10degrees flexion for both partial
and complete patellectomy.