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Patellar Fractures: Contemporary Approach to Treatment

Division of Orthopaedic Traumatology, Department of Orthopaedics, Henry Ford Hospital, Detroit.

Patellar fractures are a diverse group of injuries with a variety of fracture patterns. The surgical goals are anatomic reconstruction of the articular surface and stable fixation to allow early motion. Contemporary methods of treatment include screws, the modified tension band, and a combination of the two. Screws and wires have demonstrated specific failure patterns in experimental models, and biomechanical studies suggest that the combination of screws and wires provides more secure fixation. Partial patellectomy is the procedure of choice in comminuted fractures that cannot be anatomically reduced. Optimal treatment of patellar fractures requires individualization of surgical technique. The postoperative rehabilitation program should be based on the intraoperative findings and the stability of fixation.