Lenz Julia Elisabeth, Schraag Amadeus Dominik, Plank Luis, von Rüden Christian, Alt Volker, Weber Johannes
Department of Trauma Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany.
Department of Trauma Surgery, Orthopaedics and Hand Surgery, Klinikum Weiden, Söllnerstraße 16, 92637 Weiden, Germany.
J Clin Med. 2025 Feb 17;14(4):1335. doi: 10.3390/jcm14041335.
Patellar fractures are rare but clinically significant due to their impact on knee function. These injuries vary from simple transverse to complex comminuted patterns. Computed tomography (CT) offers superior visualization compared to radiographs, enabling accurate classification and surgical planning. This study utilized CT-based fracture mapping to analyze fracture patterns and evaluate the impact of age, trauma-center level, and AO/OTA classification. This retrospective study included 237 patients diagnosed with patellar fractures who underwent CT imaging. Fractures were classified using the AO/OTA system, and fracture mapping was performed by overlaying fracture lines onto a standardized template. Statistical analysis assessed correlations between patient demographics, trauma-center level, and fracture patterns. The cohort comprised 107 males and 130 females with a mean age of 56.9 ± 20.9 years. Males were significantly younger than females (49.2 vs. 63.3 years, < 0.001). Fractures were evenly distributed between the right (46%) and left (54%) patellae. Type C fractures were the most common (54.4%), followed by Type B (29.9%) and Type A (15.6%). Trauma-center level was inversely associated with fracture severity ( < 0.001), with complex fractures more common at lower-level centers. Age was positively correlated with fracture severity ( = 0.001). Fracture mapping revealed the central patella as the most frequently affected region, with transverse fractures extending medially and laterally, sparing the upper and lower poles. CT imaging enhances the classification and mapping of patellar fractures, highlighting the central patella as the primary site of injury. Fracture severity correlates with age and trauma-center level. These findings support CT-based mapping as a valuable tool for improving surgical planning and treatment outcomes.
髌骨骨折虽罕见,但因其对膝关节功能的影响而具有临床重要性。这些损伤范围从简单的横行骨折到复杂的粉碎性骨折。与X线片相比,计算机断层扫描(CT)能提供更清晰的图像,有助于准确分类和手术规划。本研究利用基于CT的骨折图谱分析骨折类型,并评估年龄、创伤中心级别和AO/OTA分类的影响。这项回顾性研究纳入了237例经CT成像诊断为髌骨骨折的患者。骨折采用AO/OTA系统分类,并通过将骨折线叠加在标准化模板上进行骨折图谱绘制。统计分析评估了患者人口统计学特征、创伤中心级别和骨折类型之间的相关性。该队列包括107例男性和130例女性,平均年龄为56.9±20.9岁。男性明显比女性年轻(49.2岁对63.3岁,<0.001)。骨折在右髌骨(46%)和左髌骨(54%)之间分布均匀。C型骨折最常见(54.4%),其次是B型(29.9%)和A型(15.6%)。创伤中心级别与骨折严重程度呈负相关(<0.001),复杂骨折在低级别中心更为常见。年龄与骨折严重程度呈正相关(=0.001)。骨折图谱显示髌骨中央是最常受影响的区域,横行骨折向内侧和外侧延伸,不累及上下极。CT成像增强了髌骨骨折的分类和图谱绘制,突出了髌骨中央作为主要损伤部位。骨折严重程度与年龄和创伤中心级别相关。这些发现支持基于CT的图谱绘制作为改善手术规划和治疗结果的有价值工具。