Patella fracture

Case contributed by Dr Daniel J Bell

Presentation

Fall and left knee pain with mild soft tissue swelling

Patient Data

Age: 80 years
Gender: Female
X-ray

Vertical fracture through the patella on the frontal projection. Lateral projection (HBL) shows a small suprapatellar effusion and mild OA. No lipohemarthrosis.

CT

Non-displaced vertical fracture through the lateral aspect of the patella.  No bipartite variant.  No other acute bony injury.

Degenerative disease of the knee.

Case Discussion

Vertical fractures of the patella are less common than transverse fractures, but still account for 22% of all patellar fractures 1. Fractures through the lateral patella, as here, are more common than those involving the medial facet 1

In general vertical fractures are non-displaced. It is easy to overlook these fractures on the AP projection highlighting the importance of the skyline view if a vertical-type fracture is suspected. In this case the fracture was not reported on the original read of the radiographs. However, the orthopedic surgeon reviewing the patient was suitably concerned and requested a CT which nicely demonstrates the fracture.

Vertical fractures tend to be stable and are often conservatively managed as in this case.

PlayAdd to Share

Case information

rID: 83866
Published: 6th Nov 2020
Last edited: 7th Nov 2020
Inclusion in quiz mode: Included
Institution: North Middlesex University Hospital

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.