Patella Fractures and extensor MechanisM injuries

INTRODUCTION TO PATELLAR FRACTURES ASSESSMENT OF PATELLAR FRACTURES Patellar Fracture Injury Mechanisms Injuries Associated with Patellar Fractures Signs and Symptoms Imaging and Other Diagnostic Studies Classification Outcome Measures PATHOANATOMY AND APPLIED ANATOMY RELATING TO PATELLA FRACTURES Osseous Anatomy Arterial Blood Supply Soft Tissue Anatomy BIOMECHANICS OF THE EXTENSOR MECHANISM PATELLAR FRACTURE TREATMENT OPTIONS Nonoperative Treatment Operative Treatment Open Fractures AUTHOR’S PREFERRED METHOD OF TREATMENT FOR PATELLA FRACTURES Patients with an Intact Extensor Mechanism, Vertical Fractures, and Minimal Articular Displacement or Patients Unfit for Anesthesia Displaced Fractures Postoperative Management INTRODUCTION TO EXTENSOR MECHANISM INJURIES ASSESSMENT OF EXTENSOR MECHANISM INJURIES Extensor Injury Mechanisms Injuries Associated with Extensor Mechanism Signs and Symptoms PATHOANATOMY AND APPLIED ANATOMY RELATING TO EXTENSOR MECHANISM INJURIES Imaging and Other Diagnostic Studies EXTENSOR MECHANISM INJURY TREATMENT OPTIONS Historical Perspective Nonoperative Treatment Operative Treatment AUTHOR’S PREFERRED TECHNIQUE FOR QUADRICEPS TENDON REPAIR Acute Patellar Tendon Rupture Tibial Tubercle Avulsions Acute Patellar Dislocations AUTHOR’S PREFERRED TECHNIQUE FOR ACUTE PATELLAR DISLOCATIONS MANAGEMENT OF EXPECTED ADVERSE OUTCOMES AND UNEXPECTED COMPLICATIONS IN EXTENSOR MECHANISM INJURIES Loss of Knee Motion Extensor Mechanism Weakness Symptomatic Retained Hardware Infection and Wound Complications Loss of Fixation/Refracture/Rerupture Delayed Union and Nonunion Post-traumatic Arthritis/Pain SUMMARY, CONTROVERSIES, AND FUTURE DIRECTIONS J. Stuart Melvin and Madhav A. Karunakar