Multifragmentary Fracture of the Patella

The management of multifragmentary patellar fractures with involvement of the extensor mechanism represents a significant technical challenge in orthopedics. This training offers a practical immersion in osteosynthesis that restores joint congruence and extensor function while minimizing the prominence of the material.

Training Focus:

• Surgical treatment of multifragmentary patellar fractures with involvement of the extensor mechanism.
• Anatomical reduction and stable fixation.
• Use of cannulated screws and cerclage..
• Management of secondary fragments in the lateral wing.

Detailed Content:

• Optimized Surgical Access: Precise marking and single incision to manipulate fragments intraoperatively and identify "teeth" of the fracture, facilitating reduction.
• Precise Reduction Technique: Methodology to use the reduction clamp and hand as a mold, adjusting the anchoring for primary stability without translation.
• Effective Application of Circlage: Creation of longitudinal incisions in the quadriceps tendon for proper positioning of the wire to the bone, with traction technique and burial of the ends in the muscle mass to avoid complications.
• Fixation of Lateral Fragments: Use of double compression screws for the fixation of fragments in the lateral wing, with complete burial of the head to prevent implant prominence.
• Identification of the Key Fragment: Focus on the importance of the lower pole inserted into the patellar tendon as a crucial point for the reduction and concentration of screws with washers for stabilization.
• Prevention of Complications: Strategies to avoid instability post-fixation and considerations regarding implant prominence, especially patellar plates, which often require removal.

Included Material:

• Detailed PDF: Technical document summarizing the surgical treatment of multifragmentary patellar fractures, addressing: demarcation and surgical access; reduction and stabilization techniques; preparation and fixation with cannulated screws and cerclage; fixation of lateral fragments; and final considerations, including the management of the key fragment at the inferior pole.

Enhance your skills in the treatment of complex patellar fractures. Enroll and master the osteosynthesis techniques that ensure superior functional restoration.