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LONGITUDINAL FRACTURES OF THE PATELLA
PAUL W. LAPIDUS
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Assistant Surgeon, Hospital for Ruptured and Crippled, Assistant Adjunct, Hospital for Joint Diseases
The Journal of Bone & Joint Surgery.  1932; 14:351-379 
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Abstract

1. Attention is called to typical longitudinal fracture of the patella in a vertical sagittal plane, usually over the junction of the outer and middle quarters of the patella.

2. This fracture is not as uncommon as is usually believed, but is rarely recognized.

3. Correct diagnosis of longitudinal fracture of the patella is important for the purpose of proper treatment, especially in legal cases.

4. The clinical picture is clear cut: history of injury, localized linear tenderness over the lateral border of the patella, effusion in the knee joint (usually hemorrhagic), comparatively negligible disability.

5. Special technique of roentgenography of the patella should be used in every case with the above symptoms, where there is a suspicion of longitudinal fracture.

6. Both knees should always be roentgenographed in order to differentiate the fracture from congenital anomaly of the patella.

7. Therapeutic value of repeated aspiration of the effusion in the knee joint is emphasized in cases of longitudinal fracture of the patella.

8. Longitudinal fracture of the patella may lead to a quite prolonged disability when overlooked. If properly recognized and treated, complete recovery within six to eight weeks may be expected.

9. No operative treatment should be employed in these fractures.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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