T&O: Knee pathology Flashcards
Name 2 causes for patella fracture.
- direct trauma
2. sudden forceful contraction of quadriceps muscle
How do patella fragments displace after fracture?
- Proximal fragment superiorly (pull of quadriceps tendon)
- Distal fragment inferiorly (pull or patellar ligament)
How do patellar fragments usually present?
- marked swelling and pain over patella
- point tenderness
- reduction in extension strength
- large joint effusion or haemarthrosis
How would you manage transverse fractures of the patella?
modified tension band wiring (K wire technique)
In which gender are patella dislocations more common?
Women: greater Q angle (oblique placement of femur relative to tibia)
In which direction does the patella usually dislocate? What mechanisms usually resist this?
Laterally due to imbalance between lateral pull and mechanisms resisting this:
- medial more horizontal pull of vastus medialis
- more anterior projection of lateral femoral condyle - deeper slope for larger patellar facet
Name 3 X-ray features of patella dislocation.
- lateral displacement of patella
- joint effusion
- sliver sign