Clinical:
- A 74 years old lady
- Alleged fall at home
- Complaint of painful swelling at right knee
Radiographic findings:
- There is transverse fracture line at mid right patella (white arrow).
- Minimal displacement of fracture fragment.
- There is soft tissue swelling adjacent to the fracture.
- Suprapatellar effusion is also seen (yellow arrow).
- No other fracture is seen.
- Degenerative changes of the knee joint.
Diagnosis: Patella fracture
Discussion:
- Fracture of the patella represent about 1% of all fractures.
- It is most common in those aged 20-50 years and more common in males.
- It can occur due to direct blow to patella, severe forces by extensor mechanism, after total knee reconstruction or due to pathological fracture.
- Treatment depends on degree of displacement and whether extensor mechanism is intact or disrupted.
- Non-displaced or minimally displaced fracture with intact extensor mechanism can be treated non operatively.
- Displaced fractures or disrupted extensor mechanism may require surgical treatment usually involves tension band wiring.
Progress of patient:
- Initially patient was treated conservatively with knee splint and immobilization.
- However there is widening of the displaced fracture fragments on follow up.
- Patient subsequently operative wiring band.
