About patella fx

   1. patella ?
   2. Patellar Fx ?
   3. Standard Tx?
   4. Goal ?
   5. Problem.
   6. needs.

About Himawari Method

   7. Solution by Himawari
   8. Advantage
   9. 3D movie
   10. Surgical technique
   11. Case


   12. Pre-ope evalution


About patella fx

patellar pictureWhat's Patellar?

   Patella so called ‘knee Cap’ acts like a shield for knee joint.

   The biggest sesamoid bone in human body.

   Patella plays a central role in knee extension mechanism.


What’s patellar fracture?

   About 1% of all trauma

   Falling directly onto the knee

   Most fractures are simple transverse.


What’s standard Treatment?.


   Non-displaced fractures are treated by splint or cast at knee extension for 3-4weeks.


   Displaced fractures are treated surgically.

   There are some surgical option below

     Tension band wiring

     Dirclage wiring

     Tension band wiring through canulated screw

     Braded wire




Goal of patellar fractures  soccor

   1. Establish extensor mechanism

   2. Reconstruction Patello-femoral joint.


Problem of patellar fractures  

   Fracture pattern: More complex than expected

   Fixation stability: Not enough for comminuted fracture by tension band wiring

   Irritation : tip of the K-wire cause skin irritation

   OA: incomplete reduction lead osteoarthritis



Needs for patellar fractures

   Utility: Manageable for all type of fracture

   Stability : Enough stability for all type of fractures to allow early motion

   Reliability  : low rate for loss of reduction

   Less irritation : low profile implant and low rate for implant failure

   Accuracy: complete reduction and fixation for complex fragment


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