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Patellar fractures in elderly patients: a multicenter computed tomography-based analysis

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

This study aimed to demonstrate the characteristics of patellar fractures and evaluate clinical outcomes in elderly patients.

Patients and methods

Medical records of patients aged ≥ 60 years who presented with patellar fractures were retrospectively reviewed from an institutionally approved multicenter (five institutions) orthopedic database. Patient characteristics and fracture patterns were identified, and the clinical outcomes were investigated. We compared differences according to the injury mechanism (low- vs. high-energy).

Results

A total of 202 patients [mean age, 69.4 years (range, 60–88 years); male, 89, female, 113] were included in this study. The mean follow-up period was 14.8 months (range 6–58 months), and 75% of the fractures were from low-energy injuries. According to the AO /OTA classification, the most common type was type C (136 cases, 67.3%; 33 cases, C1; 23, C2; and 80, C3), followed by type A (39 cases), type B (26 cases), and unclassified (1 case). The unclassified case was an intra-articular marginal impaction without cortical breakage. Computed tomography (CT) revealed that of the cases, 66.8% had an inferior pole involvement; 80.7%, a comminuted fragment; and 10.4%, an impacted fracture. A total of 166 fractures (82.2%) were treated surgically. The mean union time and range of motion were 13.1 weeks and 123.8° (range 30–150°), respectively. The Lysholm score was 82.1 ± 12.0, with 65.7% of the cases having excellent or good function. The complication rate was 12.4% (24 cases), including ten, four, two, and five cases of infection, fixation failure, nonunion, malunion, and pin migration, respectively. The reoperation rate was 26.4%.

Conclusion

Patellar fractures in the elderly were mostly from low-energy injuries, and types C3 and A1 were the most common. CT images demonstrated high rates of an inferior pole involvement and comminution. The complication and reoperation rates were relatively high.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea

    Jae-Ang Sim

  2. Department of Orthopaedic Surgery, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea

    Yong Bum Joo

  3. Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea

    Wonchul Choi & Seong-Eun Byun

  4. Department of Orthopaedic Surgery, Yeungnam University Medical Center, Daegu, Republic of Korea

    Oog-Jin Shon

  5. Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43 gil, Songpa-gu, Seoul, 05505, Republic of Korea

    Ji Wan Kim

  6. Department of Orthopaedic Surgery, CM Hospital, Seoul, Republic of Korea

    Young Gon Na

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  1. Jae-Ang Sim
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Corresponding author

Correspondence to Ji Wan Kim.

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Conflict of interest

All authors (Jae-Ang Sim, Yong Bum Joo, Wonchul Choi, Seong-Eun Byun, Oog-Jin Shon, and Ji Wan Kim) declare that they have no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Sim, JA., Joo, Y.B., Choi, W. et al. Patellar fractures in elderly patients: a multicenter computed tomography-based analysis. Arch Orthop Trauma Surg 141, 1439–1445 (2021). https://doi.org/10.1007/s00402-020-03526-z

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  • DOI: https://doi.org/10.1007/s00402-020-03526-z

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