Patellar Fractures and Extensor Mechanism Injuries



Figure 45.1
Representative AP, lateral, and “sunrise” radiographs of patellar fractures





What to Ask





  1. 1.


    Are there any open wounds? Possible traumatic arthrotomy/open fracture?

     

  2. 2.


    Associated injuries?

     


What to Request





  1. 1.


    Ensure the leg is stabilized, elevated, and iced immediately.

     

  2. 2.


    X-rays of the knee in AP and lateral.

     

  3. 3.


    IV access in place, initiate antibiotics if concern for open fracture.

     


When to Escalate





  1. 1.


    Open injuries: should be irrigated in ED and receive antibiotics (will require formal irrigation and debridement in OR)

     

  2. 2.


    Associated polytrauma

     


Imaging





  1. 1.


    AP, lateral of the knee. Obliques may lend additional information but not required acutely. Patella baja (a low-riding patella) is consistent with quadriceps tendon tear, while patella alta (a high-riding patella) is consistent with a patellar tendon rupture.

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Aug 4, 2017 | Posted by in MUSCULOSKELETAL MEDICINE | Comments Off on Patellar Fractures and Extensor Mechanism Injuries

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