![]() ![]() 2, 3 Fractures can also occur after total knee arthroplasty, anterior cruciate ligament (ACL) graft harvesting or due to a pathological lesion. 4 demonstrated that 66% had a comminuted fracture pattern and 85% of fractures were associated with disruption of the extensor mechanism requiring surgical fixation.Īssociated injuries may include hip dislocations, knee ligamentous injuries, femoral neck or shaft fractures and distal femur or proximal tibia fractures. 3 In a study of patellar fractures in 68 patients over the age of 65, Shabat et al. There is conflicting data on whether each decade of life adds further risk of a patellar fracture. 3 The risk of patellar fracture is about 3.5 times higher in women than men. from a national database of patients the over the age of 65 years. Patellar fractures represent about 1% of all fractures, 1, 2 with an incidence in the elderly of 0. Options for treatment include non-operative management, open reduction internal fixation, partial patellectomy and in rare cases total patellectomy. Treatment is guided by bone quality, fracture pattern, physical examination, as well as the patient’s functional status and medical comorbidities. ![]() The primary goal of management in the elderly patient is to regain function. In the elderly patient, fractures can also occur around a total knee arthroplasty or could be due to a pathological lesion. Fractures of the patella most commonly occur following a simple fall in the elderly, with open fractures rare. The patella shifts the moment arm of the quadriceps anteriorly thereby increasing the efficiency of the extension force. It serves as the fulcrum of the extensor mechanism between the quadriceps and patellar tendons. The patella is the largest sesamoid bone in the human body. ![]()
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