ABSTRACT
The patella is the largest sesamoid bone in the human body. It serves as the fulcrum of the extensor mechanism between the quadriceps and patellar tendons. Fractures of the patella can be caused by either a direct blow or indirectly through eccentric contraction of the quadriceps. The commonly utilized classification systems for patellar fractures are descriptive in nature. Patellar fractures should be evaluated using anteroposterior, lateral and sunrise X-ray views. Non-displaced fracture patterns are amenable to non-operative treatment. Fractures may be transverse, stellate or vertical. Complete patellectomy can lead to decreased efficiency of the extensor mechanism. Treatment of patellar fractures after total knee arthroplasty can be guided by three main criteria: integrity of the extensor mechanism, fixation status of the patellar implant and quality of the remaining bone. Fractures of the patella most commonly occur following a low energy simple fall in the elderly, with comminuted fractures.
