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A patella fracture is a break of the kneecap. [1] Symptoms include pain, swelling, and bruising to the front of the knee. [1] A person may also be unable to walk. [1]
The patella rests in the trochlear, which is found in the distal part of the femur. The patella can dislocate from the groove because of trauma or an unnatural twisting of the knee. [5] When dislocated, the soft tissue layer that the patella rests in is damaged; the patella is forced out of its groove and back into place.
The bones of the knee are the femur, patella, tibia, and fibula. The fibula is on the lateral side of the knee and the patella has little effect on the medial side of the knee. The bony congruity of the medial knee consists of the opposing surfaces of the medial femoral condyle and the medial tibial plateau.
The osteochondral fracture occurs on the weight-bearing portion of the lateral condyle. Typically, the condyle will fracture (and the patella may dislocate) as a result of severe impaction from activities such as downhill skiing and parachuting. [1] Open reduction and internal fixation surgery is typically used to repair an osteochondral fracture.
A patella alta is a high-riding (superiorly aligned) patella. An attenuated patella alta is an unusually small patella that develops out of and above the joint. A patella baja is a low-riding patella. A long-standing patella baja may result in extensor dysfunction. [5] Insall-Salvati ratio (A divided by B). [6]
On a normal radiograph, the line intersects the inferior pole of the patella, and so can be useful in diagnosing a broken femur as well as a patellar tendon rupture. It also helps to define "Schottle point" intra-operatively for reconstruction of MPFL(Medial patello-femoral ligament.) [3] It may also be used to describe the course of an ACL graft.
With a tourniquet applied, the tendon is exposed through a midline longitudinal incision extending from the upper patellar pole to the tibial tuberosity. The tendon is either avulsed (detached) from the lower patellar pole or lacerated. Even so, the continuity and tone of the tendon should be restored, taking into consideration the patellar height.
A patellar dislocation is a knee injury in which the patella (kneecap) slips out of its normal position. [5] Often the knee is partly bent, painful and swollen. [1] [2] The patella is also often felt and seen out of place. [1] Complications may include a patella fracture or arthritis. [3]
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