Multifragmentary patellar fracture has a distinct fracture pattern which makes coronal split, inferior pole, or satellite fragments

Jae-Woo Cho,Hanju Kim,Zepa Yang,Seungyeob Sakong,Wonseok Choi,Beom-Soo Kim,Eic Ju Lim,Whee Sung Son,An Seong Chang,Do-Young Lim,Jong-Keon Oh,Youngwoo Kim

doi:10.1038/s41598-021-02215-0

Abstract

The present study aimed to map the location and frequency of fracture lines on the coronal articular and sagittal planes in multifragmentary patellar fractures. 66 multifragmentary patellar fractures were digitally reconstructed using the 3D CT mapping technique. The coronal articular surface and midsagittal fracture maps were produced by superimposing each case over a single template. Each fracture line was classified based on the initial displacement and orientation. We evaluated the frequency and direction of the fracture line, coronal split fragment area, and satellite and inferior pole fragment presence. Coronal articular surface fracture mapping identified primary horizontal fracture lines between the middle and inferior one-third of the articular surface in 63 patients (95.4%). Secondary horizontal fracture lines running on the inferior border of the articular facet were confirmed (83.3%). Secondary vertical fracture lines creating satellite fragments were mostly located on the periphery of the bilateral facet. Midsagittal fracture mapping of primary and secondary horizontal fracture lines with the main coronal fracture line revealed a predominantly X-shaped fracture map. The consequent coronal split fragment and inferior pole fracture were combined in most cases. In conclusion, the multifragmentary patellar fracture has a distinct pattern which makes coronal split, inferior pole, or satellite fragments.

Highlights

The present study aimed to map the location and frequency of fracture lines on the coronal articular and sagittal planes in multifragmentary patellar fractures. 66 multifragmentary patellar fractures were digitally reconstructed using the 3D computed tomography (CT) mapping technique
The fracture mapping technique described by Cole et al.[14] was applied in this study to evaluate the fracture patterns of AO/OTA 34 C3 multifragmentary patellar fractures
To the best of our knowledge, this technique has been used to identify the fracture patterns of complex articular fractures, including scapular fractures[15], pilon fractures[14], tibial plateau f ractures[16,17], posterior malleolar ankle f ractures[18], Hoffa f ractures[19], distal radius fractures[20], and quadrilateral plate fractures[21]

Summary

Introduction

The present study aimed to map the location and frequency of fracture lines on the coronal articular and sagittal planes in multifragmentary patellar fractures. 66 multifragmentary patellar fractures were digitally reconstructed using the 3D CT mapping technique. The present study aimed to map the location and frequency of fracture lines on the coronal articular and sagittal planes in multifragmentary patellar fractures. The multifragmentary patellar fracture has a distinct pattern which makes coronal split, inferior pole, or satellite fragments. Comminuted patellar fractures were frequently associated with coronal split fractures and inferior pole comminution[8–11] This complex fracture type, which is described as a complete articular frontal/coronal multifragmentary patellar fracture, is classified as a 34C3 fracture, according to the current AO/OTA classification[12,13]. The present study aimed to define the location and frequency of fracture lines on the coronal and sagittal planes of the articular surface and to map the locations of articular impaction in AO/OTA 34C3 fractures

Methods

Results

Conclusion