|
Year |
2002 |
|---|---|
|
Question Number |
73. |
|
Category |
Pediatric Orthopaedics |
Question
Figures
Answer (click for answer)
Non surgical management is indicated for all non-displaced patellar fractures and for minimally displaced (2-3mm) fractures with an intact extensor mechanism. This 7 year old boy has both a displaced fracture and an incompetent extensor mechanism and needs an ORIF. A sleeve fracture is another term for an avulsion fracture. The anterior tension band wiring technique is the standard treatment for transverse patellar fracture pattern. A compression dressing as definitive treatment is not appropriate in this setting. Closed reduction is not appropriate (a soon as the quad activates, the patellar fracture will displace, healing will occur with an extension lag – or go on to non-union). Cast immobilization adds the negative attributes of not treating the fracture and preventing any possibility of early ROM.
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