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Patella Fracture
Kirkland W. Davis, MD, FACR; Andrew Sonin, MD, FACR; Donna G. Blankenbaker, MD, FACR
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Synonyms

            • Kneecap fracture
          • Definitions

            • Patella fracture ± extensor mechanism disruption
            • Extensor mechanism: quadriceps tendon, patella, and patellar tendon
              • Also includes medial and lateral retinacula, patellofemoral ligaments

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        • Reporting Tips

                                          Selected References

                                          1. Lombardo DJ et al: Periprosthetic fractures about total knee arthroplasty. Musculoskelet Surg. 104(2):135-43, 2020
                                          2. Putman S et al: Patellar complications after total knee arthroplasty. Orthop Traumatol Surg Res. 105(1S):S43-S51, 2019
                                          3. Maloney E et al: The pediatric patella: normal development, anatomical variants and malformations, stability, imaging, and injury patterns. Semin Musculoskelet Radiol. 22(1):81-94, 2018
                                          4. Sanal HT et al: Imaging following fractures of and around the knee. Semin Musculoskelet Radiol. 22(4):457-63, 2018
                                          5. Jarraya M et al: Imaging of patellar fractures. Insights Imaging. 8(1):49-57, 2017
                                          6. Della Rocca GJ: Displaced patella fractures. J Knee Surg. 26(5):293-9, 2013
                                          7. Lazaro LE et al: Effect of computerized tomography on classification and treatment plan for patellar fractures. J Orthop Trauma. 27(6):336-44, 2013
                                          8. Lee BJ et al: Adolescent patellar osteochondral fracture following patellar dislocation. Knee Surg Sports Traumatol Arthrosc. 21(8):1856-61, 2013
                                          9. Dy CJ et al: Meta-analysis of re-operation, nonunion, and infection after open reduction and internal fixation of patella fractures. J Trauma Acute Care Surg. 73(4):928-32, 2012
                                          10. Dupuis CS et al: Injuries and conditions of the extensor mechanism of the pediatric knee. Radiographics. 29(3):877-86, 2009
                                          11. Sheth NP et al: Periprosthetic patellar fractures. J Bone Joint Surg Am. 89(10):2285-96, 2007
                                          12. Drabicki RR et al: Stress fractures around the knee. Clin Sports Med. 25(1):105-15, ix, 2006
                                          13. Gupta RR et al: Patellar sleeve fractures in children: a case report and review of the literature. Am J Orthop. 35(7):336-8, 2006
                                          14. Tay GH et al: Indirect patella fractures following ACL reconstruction: a review. Acta Orthop. 77(3):494-500, 2006
                                          15. Chun KA, et al: Patellar fractures after total knee replacement. AJR Am J Roentgenol. 185(3):655-60, 2005
                                          16. Hunt DM et al: A review of sleeve fractures of the patella in children. Knee. 12(1):3-7, 2005
                                          17. Mayers LB et al: Acute transverse patellar fracture associated with weightlifting. Case report and literature review. Am J Sports Med. 29(2):232-3, 2001
                                          18. Carpenter JE et al: Fractures of the patella. Instr Course Lect. 43:97-108, 1994
                                          19. Sonin AH: Magnetic resonance imaging of the extensor mechanism. Magn Reson Imaging Clin N Am. 2(3):401-11, 1994
                                          20. Yu JS et al: MR imaging of injuries of the extensor mechanism of the knee. Radiographics. 14(3):541-51, 1994
                                          21. Salerno DJ: Fractures of the patella: closed and open repair versus patellectomy. J Am Osteopath Assoc. 74(6):538-41, 1975
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Synonyms

                                                    • Kneecap fracture
                                                  • Definitions

                                                    • Patella fracture ± extensor mechanism disruption
                                                    • Extensor mechanism: quadriceps tendon, patella, and patellar tendon
                                                      • Also includes medial and lateral retinacula, patellofemoral ligaments

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            • Nuclear Medicine Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Consider

                                                                              • Image Interpretation Pearls

                                                                                • Reporting Tips

                                                                                  Selected References

                                                                                  1. Lombardo DJ et al: Periprosthetic fractures about total knee arthroplasty. Musculoskelet Surg. 104(2):135-43, 2020
                                                                                  2. Putman S et al: Patellar complications after total knee arthroplasty. Orthop Traumatol Surg Res. 105(1S):S43-S51, 2019
                                                                                  3. Maloney E et al: The pediatric patella: normal development, anatomical variants and malformations, stability, imaging, and injury patterns. Semin Musculoskelet Radiol. 22(1):81-94, 2018
                                                                                  4. Sanal HT et al: Imaging following fractures of and around the knee. Semin Musculoskelet Radiol. 22(4):457-63, 2018
                                                                                  5. Jarraya M et al: Imaging of patellar fractures. Insights Imaging. 8(1):49-57, 2017
                                                                                  6. Della Rocca GJ: Displaced patella fractures. J Knee Surg. 26(5):293-9, 2013
                                                                                  7. Lazaro LE et al: Effect of computerized tomography on classification and treatment plan for patellar fractures. J Orthop Trauma. 27(6):336-44, 2013
                                                                                  8. Lee BJ et al: Adolescent patellar osteochondral fracture following patellar dislocation. Knee Surg Sports Traumatol Arthrosc. 21(8):1856-61, 2013
                                                                                  9. Dy CJ et al: Meta-analysis of re-operation, nonunion, and infection after open reduction and internal fixation of patella fractures. J Trauma Acute Care Surg. 73(4):928-32, 2012
                                                                                  10. Dupuis CS et al: Injuries and conditions of the extensor mechanism of the pediatric knee. Radiographics. 29(3):877-86, 2009
                                                                                  11. Sheth NP et al: Periprosthetic patellar fractures. J Bone Joint Surg Am. 89(10):2285-96, 2007
                                                                                  12. Drabicki RR et al: Stress fractures around the knee. Clin Sports Med. 25(1):105-15, ix, 2006
                                                                                  13. Gupta RR et al: Patellar sleeve fractures in children: a case report and review of the literature. Am J Orthop. 35(7):336-8, 2006
                                                                                  14. Tay GH et al: Indirect patella fractures following ACL reconstruction: a review. Acta Orthop. 77(3):494-500, 2006
                                                                                  15. Chun KA, et al: Patellar fractures after total knee replacement. AJR Am J Roentgenol. 185(3):655-60, 2005
                                                                                  16. Hunt DM et al: A review of sleeve fractures of the patella in children. Knee. 12(1):3-7, 2005
                                                                                  17. Mayers LB et al: Acute transverse patellar fracture associated with weightlifting. Case report and literature review. Am J Sports Med. 29(2):232-3, 2001
                                                                                  18. Carpenter JE et al: Fractures of the patella. Instr Course Lect. 43:97-108, 1994
                                                                                  19. Sonin AH: Magnetic resonance imaging of the extensor mechanism. Magn Reson Imaging Clin N Am. 2(3):401-11, 1994
                                                                                  20. Yu JS et al: MR imaging of injuries of the extensor mechanism of the knee. Radiographics. 14(3):541-51, 1994
                                                                                  21. Salerno DJ: Fractures of the patella: closed and open repair versus patellectomy. J Am Osteopath Assoc. 74(6):538-41, 1975