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Patella Fracture Treatment

Treatment of patellar fracture, should be to maximize the restoration of the smooth articular surface, to give a more solid fixation and early knee joint activity to prevent the occurrence of traumatic arthritis.

1. Gypsum-based care or possession of a fixed
This law applies to a non-displaced patellar fracture, without manual reduction, intra-articular blood out, bandage, care, or with long legs plaster cast limb fixed in extension position 3 ~ 4 weeks. Cast immobilization in the quadriceps contraction during the exercise, remove the plaster after care knee activity practice.

2. Open reduction and fixation
Fixation of patella fractures multiple methods can be divided into two categories, one category of fixed-line still needs a certain period of time after the external fixation; the other relatively strong internal fixation without external fixation.

1) Modified tension band wire fixation

  • Indications: a. run patella fracture; b. Comminuted patella can be reset.
  • surgical methods: pre-patellar transverse incision line arc, reveal fracture line, since the far end of fractures noodle packs, retrograde and out using two 1.5mm diameter Kirschner wire fixation of the fracture, into the intra-articular hand, touch the patella After the formation of articular surface with a wire around the Kirschner wire fixation. Another way to use the same fixed needle.
  • after treatment: I do not need external fixation, quadriceps contraction after the second day of practice, the majority of fracture patients at two weeks after operation to 90 ° flexion and walking fields.

    2) Patella or on the lower pole resection, re-quadriceps tendon surgery

  • removal of small pieces or crush fractures of the patellar tendon to the patella on paragraph, or in quadriceps patellar fracture.
  • after treatment: dressings with dressings, long legs stretched gypsum-bit fixed three weeks, do not go after the weight-bearing exercises gypsum joint activity. Fu Po 6 weeks after weight-bearing walking gradually and to strengthen the range of motion and quadriceps exercises. This method may be the role of preservation of the patella, to heal quickly, Unit 4 features to restore, no fracture healing and articular surface is not smooth problem.

    3) Patella resection
    Reduction should not apply, should not severely comminuted fracture of partial resection. Comminuted fracture block resection should try to protect their quadriceps aponeurosis and periosteum. Suture after excision of the expansion of the Department of tearing and joint capsule to restore to normal tightness. Then, drop the quadriceps tendon and patellar tendon suture. Can not direct suture, and can be reversed quadriceps tendon suture repair. Make up the quadriceps tendon in the "V"-shaped incision, to cut under the flap over the tendon, patellar excision repair of the defect after the new form. Vastus lateralis muscle can also be used and the quadriceps tendon of the lateral tendon flip down flap excision repair defect of the patella Department. After four weeks of fixed plaster care and practice activities flexed knee.

    • Submitted by Health Studies on Tue, 04/07/2009 - 21:09
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