patella fracture

Patellar injury episode

Record the affected patella and distinguish reported mechanism from clinician interpretation.

1. Which patella is affected, when did symptoms begin, and is this a new injury or reassessment of an existing fracture? definition
2. Who reported the mechanism, and what evidence supports an acute impact, traction event or another cause? provenance

Patellar fracture evidence

Retain the interpreting clinician's conclusion and any unresolved distinction from a developmental variant or neighbouring injury.

1. Which examination and imaging findings establish disruption of the patella, and who interpreted them? provenance
2. How were bipartite patella, isolated tendon rupture and patellar dislocation considered or excluded? boundary

Location and fragmentation

Record location, orientation and fragmentation without forcing an uncertain pattern into a single category.

1. Does the fracture involve the superior pole, body, inferior pole or multiple regions, and what is its orientation? definition
2. How many fragments are identifiable, and what uncertainty remains about small, overlapping or osteochondral fragments? measurement

Gap and step-off

Store reproducible measurements and their limitations rather than substituting an unexplained displaced or nondisplaced label.

1. What are the measured interfragmentary gap and articular step-off, on which images and at which locations? measurement
2. Are serial images sufficiently comparable to establish a change in alignment, or is further imaging interpretation needed? action

Active extension assessment

Patellar fracture can compromise knee extension; record the actual functional examination. [Cleveland Clinic](https://my.clevelandclinic.org/health/diseases/22081-patella-fracture)

1. Can the person actively extend the knee and maintain a straight-leg raise, and how did pain or examination conditions limit assessment? measurement
2. What evidence supports associated retinacular, quadriceps tendon or patellar tendon disruption? provenance

Open fracture status

Open patellar fractures require urgent treatment because of infection risk. [AAOS](https://www.orthoinfo.org/diseases--conditions/patellar-kneecap-fractures/)

1. Is wound communication with the fracture confirmed, excluded or uncertain, and who assessed it? boundary
2. What urgent clinical review was requested for the documented wound or associated limb findings, and has responsibility been accepted? action

Management rationale

Record the clinician-selected operative or nonoperative pathway, alternatives considered and unresolved decision factors.

1. How did alignment, extension function, wound status and individual circumstances inform the selected treatment? action
2. If surgery occurred, what fixation, fragment removal or tendon repair was documented, and where is the operative record? provenance

Authorised knee use

Loading and movement restrictions should reflect the treating clinician's individual instructions. [AAOS](https://www.orthoinfo.org/diseases--conditions/patellar-kneecap-fractures/)

1. What weight-bearing allowance, brace position and permitted knee-motion range are currently prescribed? action
2. Who may change these restrictions, and which clinical or imaging review must precede progression? action

Fracture healing trajectory

Keep imaging observations, symptoms and the clinical conclusion distinguishable at each follow-up.

1. What serial evidence supports progressive union and maintained fragment alignment? measurement
2. What findings prompted review for delayed healing, loss of reduction, infection or fixation problems? action

Functional recovery

Persistent pain, stiffness and weakness can accompany recovery; track these separately from union. [Cleveland Clinic](https://my.clevelandclinic.org/health/diseases/22081-patella-fracture)

1. How have extension lag, flexion range, quadriceps performance and personally relevant tasks changed from baseline? measurement
2. What assessment supports attributing persistent symptoms to the fracture, joint injury, implants or another condition? boundary
3. Which functional criteria and clinician authorisation support return to work, sport or unrestricted activity? action

Check these first

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these check these first hold for the sense of patella fracture this model covers, and on what evidence? provenance

Kinds and varieties

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these kinds and varieties hold for the sense of patella fracture this model covers, and on what evidence? provenance

Identifiers and schemes

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these identifiers and schemes hold for the sense of patella fracture this model covers, and on what evidence? provenance

Real-world use

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these real-world use hold for the sense of patella fracture this model covers, and on what evidence? provenance

Typical measurements

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these typical measurements hold for the sense of patella fracture this model covers, and on what evidence? provenance

Failure modes and hazards

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these failure modes and hazards hold for the sense of patella fracture this model covers, and on what evidence? provenance

Regional variation

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these regional variation hold for the sense of patella fracture this model covers, and on what evidence? provenance

Neighbouring kinds and how to tell them apart

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these neighbouring kinds and how to tell them apart hold for the sense of patella fracture this model covers, and on what evidence? provenance