Fracture of the Pattela

The anatomy of the knee is basically composed by three bones that are held together with the help of muscles and tendons. The patella is the bone-shaped lid, which lies between the femur and the tibia. This is located in the terminal tendon of the femoris quadriceps muscles and is ahead of the lower end of the femur. The patella plays an important role as part of the extensor mechanism of the knee, in addition to serving as protection against direct traumas. Likewise, it provides a better aesthetic appearance to the knee.

The fracture of the patella (FR) is frequently observed in emergency services. Its behavior varies depending on the intensity of trauma. This one is usually caused by a direct or and indirect blow, sometimes are both. Athletes, such as football players, have a high probability to suffer fractures. These are classified according to their displacement, as displaced or non-displaced, and according to the stroke of the fracture, as transverse, vertical, marginal, osteochondral and comminuted. To determine the severity of the injury, is important to inspect the area and the movement ability of the active leg extension. From these observations, the doctors can suspect if the patient has suffered a fracture and then they proceeds to confirm the diagnosis by radiography.

According to different sources, treatment may be conservative or surgical. When a patient comes to the emergency room with signs of fracture of the patella, the first thing to do is try to reduce the pain by applying ice or analgesics. After determining the severity of the injury, the treatment is determined. The conservative is to those patients who retain the continuity of the extensor mechanism and non-displaced fracture. This treatment is to immobilize the area for an approximately period of three weeks and, after that, to rehabilitate the patient by physiotherapy, until the bone is consolidated. Moreover, surgical treatment aims to achieve anatomic reduction, restore the congruence of the articular surface and the integrity of the extensor mechanism. To accomplish this, there are a variety of techniques, such as the previous tension banding or a partial and total patellectomy. For most of the techniques, doctors used different instruments like screws, cerclage wire, Herbert's screws and bio-absorbable fixation implants for osteochondral fragments.

In conclusion, the patella fracture is very common in people, especially in athletes. Their treatment varies according to the extensor movement that exerts the patella. If the patient's patella does not comply with its functions, it should try to surgically. The recovery is completed by physiotherapy techniques that helps strengthen the bone and improve the extensor movement.