Comminuted patella fracture in elderly patients: a systematic review and case report

Matthews, Brent, Hazratwala, Kaushik, and Barroso-Rosa, Sergio (2017) Comminuted patella fracture in elderly patients: a systematic review and case report. Geriatric Orthopaedic Surgery & Rehabilitation, 8 (3). pp. 135-144.

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Objectives: To review comminuted patella fracture in the elderly patients and examine the surgical options to avoid compli-cations such as fixation failure and poor functional outcome. To provide an example of mesh augmentation in comminuted patellafracture in the elderly patients.

Data Sources: A literature review was conducted by the authors independently using Ovid,Medline, Cochrane, PubMed, and Clinical Key in English. We aimed to review data on patients older than 65 with comminutedpatella fracture. Search conducted between July and December 2015.

Study Selection: Search terms included patella fracture,elderly, and fixation failure. Abstracts were included if they were a case report, cohort series, or randomized control trial. Furtherinclusion criteria were that they were available in full text and included patient age(s), operative details, follow-up, and outcomediscussion.

Data Extraction: Each study was assessed according to its level of evidence, number of patients, age of patients,fracture patterns described, complications of treatment, and results summarized.

Data Synthesis: Paucity of data and het-erogeneity of studies limited statistical analysis. Data are presented as a review table with the key points summarized.

Conclusion:In patella fracture, age >65 years and comminuted fracture pattern are predictors of increased fixation failure andpostoperative stiffness, warranting special consideration. There is a trend toward improved functional outcomes when aug-mented fixation using mesh or plates is used in this group. Further level 1 studies are required to compare and validate newtreatment options and compared them to standard surgical technique of tension band wire construct

Item ID: 67117
Item Type: Article (Research - C1)
ISSN: 2151-4593
Keywords: patella, fracture, osteopenia, fixation failure, tension band wire, patella plating, patella mesh
Copyright Information: Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License( which permits non-commercial use, reproduction and distribution of the work without further permissionprovided the original work is attributed as specified on the SAGE and Open Access pages (
Date Deposited: 03 Aug 2021 02:56
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320216 Orthopaedics @ 100%
SEO Codes: 20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 100%
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