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Author Topic: Fractured Patella  (Read 585 times)

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Offline Megheart

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Fractured Patella
« on: April 25, 2019, 08:27:31 AM »
Hello all,

I have a few questions regarding fractured patellas.

Last week after falling onto a concrete surface I experienced intense pain in my left knee. After icing the knee for 20 minutes or so, I realised this was not going to go away in a hurry, so I went to my local hospital emergency department.

The upshot was, an xray revealed a ‘comminuted, minimally displaced fracture with absent SLR’ (straight leg raise). I was told they would probably take me to theatre that afternoon to have the patella wired together. This plan was changed however and instead, was put into a thigh to ankle splint and given crutches and told I would be called for an orthopaedic appointment within 10 days. They would then redo the xray and decide, based on whether bone knitting was happening, what the course of action would be.

I am still awaiting that appointment.

In the last few days I have done some reading up on this type of fracture and it seems that most comminuted and displaced fractures of the patella with absent SLR have surgical intervention. One of my questions is, does the same apply if it is only minimally displaced?

Is the post operative outcome worth having the surgery? So if for instance my case was a borderline ‘to have surgery’ or ‘not to have surgery’, which should I choose?

Also, has anyone had a low profile revision mesh plating done as treatment rather than the conventional TBW (tension band rewiring) and cerclage type of repair?

I’m sure I’ll have more questions but for now that’s it.


Offline axand

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Re: Fractured Patella
« Reply #1 on: May 06, 2019, 02:54:16 PM »
Hello Megheart,

Like you I had a similar fracture, but in my country (Romania) all the doctors told me that surgery is required for best result (now I am around 10 months from the fall and surgery) and in my case I have 2 wires and 3 screws. And the fracture at the last appointment was not fully healed. So I would say that event with surgery there can be a issue, but also without surgery the bone pieces may move even more..

I have heard about a mesh plating and even met a case like this, but was for an old 70year lady and she haven't recovered completely (strength and flexibility). But from what I've read and also in my case to be honest... I think the 2 pins and the figure 8 are the most used, and it makes sense because when the tendons will try to pull apart the patella the tension wire will make the bone pieces stay in place.. for my case with 3 pins and 2 wires (cerclage) I think there was still some bone movement when I started the PT.

However I think you should ask the doctor for advantages and disadvantages if going with the surgery or not so that you can put in balance what to chose. Unfortunately you will know only on the long term if you made the right decision (since after the patella heals, there can be other issues that can cause the cartilage to damage or issue with the muscle atrophy that can cause pain in the knee...) It all depends on our body ability to heal and also the condition that you where before the accident.

Good luck in tacking the best decision for you and to have a fast recovery!