Developments in the epidemiology and surgical management of patella fractures in Germany

Abstract

Background Patella fractures account for approximately 1% of all skeletal injuries. Treatment options are vast and no definitive conclusion on what option is the most beneficial could be made so far. Plate osteosynthesis appears to gain in importance. We aim to give insight into the more recent trends and developments as well as establish the epidemiology of patella fractures in Germany by analysing treatment and epidemiological data from a national database. Methods Anonymised data was retrieved form a national database. In the period of 2006 to 2020, all patients with patella fractures as defined in ICD-10 GM as their main diagnosis, who were treated in a German hospital were included. Patients were divided into subgroups based on gender and age. Age groups were created in 10-year intervals from 20 years old up to 80 years old with one group each encompassing all those above the age of 80 years old and below 20 years old and younger. Linear regression was performed were possible to determine statistical significance of possible trends. Results A total of 151,435 patellar fractures were reported. 95,221 surgical interventions were performed. Women were about 1.5 times more likely to suffer from patella fracture than men. The relative number of surgical interventions rose from about 50% in 2006 to 75% in 2020. Most surgical interventions are performed in those over the age of 50. The incidence of complex fractures and plate osteosynthesis has significantly increased throughout the analysed period. Conclusions We found a clear trend for surgical treatment in Germany with an increase in surgical procedures. We could also show that this ratio is age-related, making it more likely for younger patients in the age groups from 0 to 70 years old to receive surgical treatment for their patella fracture.

Impetigo Surgical Site Infection Following Open Reduction and Internal Fixation of a Patella Fracture

“…The mean time of occurrence for surgical site infections is between three and seven days, but many studies have reported a wide variance in the timeline [ 7 ]. The mean time of occurrence of surgical site infections after patellar fractures was found to vary significantly between studies, with studies reporting averages ranging from 5 days to 29.5 days with no genetic sex predominance [ 2 , 4 , 8 ]. This demonstrates that the presentation time of surgical site infections can vary depending on various factors, such as the extent and mechanism of injury, type of surgery, and reporting time, as some signs of infection may not be immediately noticed or reported.…”

“…Patellar fractures are most frequently reported in older adults, suggesting a possible osteoporotic/osteopenic component to the etiology. Rau et al reported that women are at 1.5 times greater risk for patellar fractures, with the highest incidence in the 60 to 80-year-old age group, further supporting the osteoporotic theory [2]. Other sources report that males are at two times greater risk, demonstrating a contradiction in the literature on the genetic sex predominance for patellar fractures [1].…”

“…Patellar fractures account for approximately one percent of all fractures, with an increasing prevalence with age and a discrepancy in genetic sex predominance [ 1 , 2 ]. Treatment can vary from conservative management to surgery, with typical surgical indications including a disruption in the extensor mechanism, open fractures, and an articular stepoff of two millimeters or greater [ 3 ].…”