Fractured patella in children: Preservation of the patellar dimensions

Objectives: The progressive understanding of the mechanicalfunction of the patella makes preservation of itsgeometry is mandatory, particularly during its reconstruction.Objectives of this study were to compare the patellardimensions after surgical and conservative treatment forpatellar fractures in children and to present influence ofthe changes in the patellar dimensions on the knee motions.Materials and methods: Two groups of children with patellarfractures their ages at time of injury averaged 12years. One group included five children, was treated surgicallyusing of the inter-fragmentary wiring technique andthe other group that includes seven children was treatedconservatively. Patients were prospectively followed for aperiod-averaged 65.5 months, the knee function and thepatellar dimensions were assessed clinically and radiographically.Results: The group was treated surgically reported insignificantincrease in the patellar longitudinal length andreported no extension lag; however, reported average 9°flexion deficit, which is possibly correlated to radiographicincrease of the patellar thickness. The group was treatedconservatively reported significant increase in the patellarlongitudinal length and reported extension lag averaged4.3° and flexion deficit averaged 7.14°.Conclusions: Surgical treatment preserved to great extentthe longitudinal patellar length but it failed to preservethe patellar thickness particularly in the comminuted patellarfractures. The patellar elongation caused extensionlag and flexion deficit while the mere increase of the patellarthickness produced flexion deficit without extensionlag.Key words: Patella, dimensions, fracture, knee motion,children