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Patella Fracture ORIF 27524

Displaced patella fracture lateral view xray

Displaced patella fracture A/P view

ORIF patella fracture lateral view xray

ORIF patella fracture A/P xray

synonyms:Patella Fracture ORIF, patellar fracture ORIF, knee cap ORIF

ORIF Patella CPT

ORIF Patella Indications

  • Displaced transverse patella fracture

ORIF Patella Contraindications

ORIF Patella Alternatives

ORIF Patella Pre-op Planning

  • Ensure appropriate screws and wires are available.  4.0 cannulated screws. 

ORIF Patella Technique

  • Sign operative site.
  • Pre-operative antibiotics, +/- regional block.
  • General endotracheal anesthesia
  • Supine position on radiolucent OR table. All bony prominences well padded.
  • Examination under anesthesia.
  • Well-padded tourniquet high on the thigh.
  • Prep and drape in standard sterile fashion.
  • Vertical midline incision.
  • Expose fracture site, medial and lateral retinaculum.
  • Fracture reduced with reduction forceps. Reduction judged based on palpation of articular surface and c-arm images.
  • Fixation provided with 4.5mm cannulated screws and tension band created with #2 fiberwire suture placed through the cannulated screws.
  • Severely comminuted fractures require cerclage fixation (wire/suture)
  • Free osteochondral fragments require repair or excision.
  • Repair medial and lateral retinaculum.
  • Irrigate.
  • Close in layers.

ORIF Patella Complications

ORIF Patella Follow-up care

  • Post-op: knee brace locked in extention, WBAT in brace
  • 7-10 Days: Wound check, confirm reduction on xray. Consider allowing knee ROM to some degree based on stability of fixation at surgery.
  • 6 Weeks: Evaluate xrays for union. Advance ROM
  • 3 Months: progress with ROM and strengthening
  • 6 Months: review xrays, return to full activity / sport
  • 1Yr: f/u xrays, assess outcome.

ORIF Patella Outcomes

ORIF Patella Review References

  • Melvin JS, JAAOS 2011;19:198
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