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Abstract
Patellar fractures constitute approximately 1 percent of skeletal injuries in the literature and 3.4 percent in the authors institution. The goals of treatment are restoration of the entensor mechanism and perfect restoration of the articulating surface. In contrast to most other intraarticular fractures, the selection of treatment must take into consitleration tensile suess of the bone, as were as compressive stress.
The basic schema for treatment of patellar fracture is as follows:
1. To determine therapy, patellar fractures must be classified in 3 models;The mechanism of injury. amount of displacement, and configuration of fracture.
2. Nonoperative treatment is indicated if the extensor retinaculum is intact and if displacement of fragment is minimal.
3. The success of operative treatment depends on the exact reduction of fracture, secure fixation, and the amount of articular cartilage damage.
4. Recent biomechanical studies on the efficiency of various forms of fixation for patellar fractures showed that fixation with modified tension band wiring with or without circumferentiat wiring was superior to tension band wiring or circumferential wiring.
5. Partial patellectomy should be selected in preference to total patellectomy if at all possible because partial patellectomy offers better function.
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