Patella fractures account for 1% of all skeletal injuries and are critical to knee extension biomechanics. Master the tension band principle, AO classificationand surgical decision-making for displaced patellar fractures. ⏱ Chapters 0:00 Intro 0:24 Essentials 0:57 Classification 1:27 Ao 1:57 Gaps 2:27 Lever 2:58 Biomechanics 3:28 Algorithm 4:02 Numbers 4:33 Clinical reasoning — Extension 5:02 Clinical reasoning — Implant This Orthovellum masterclass provides a comprehensive deep dive into the assessment, classificationand management of patella fractures. We explore the biomechanics of the extensor mechanism, the GAPS mnemonic for operative indicationsand how tension band wiring converts destructive tensile forces into healing articular compression. 🦴 IN THIS VIDEO YOU'LL LEARN • How to classify patella fractures using both descriptive patterns and the AO/OTA (bone 34) system • The biomechanical function of the patella using the LEVER mnemonic to understand extensor power • How to apply the GAPS mnemonic to identify crucial operative indications for patellar fractures • The mechanical principles of tension band wiring and how it converts tensile forces into dynamic compression • Why testing active knee extension before administering analgesia is a critical clinical step • The differences between managing transverse fractures, vertical splitsand highly comminuted patterns • Decision-making frameworks for choosing between conservative cylinder casting and ORIF • The clinical importance of the medial and lateral retinacular tissues during fracture assessment • Indications and techniques for partial patellectomy versus hardware fixation in severe injuries ⏱️ CHAPTERS 📌 KEY TAKEAWAYS ✔️ Operative fixation is indicated if fracture displacement exceeds 2-3mm or articular step-off exceeds 2mm ✔️ Always assess active straight leg raise BEFORE giving analgesia to avoid masking a disrupted extensor mechanism ✔️ Tension band fixation works by converting anterior tensile forces into beneficial articular compression during knee flexion ✔️ Around 50% of patients require hardware removal after K-wire fixation due to soft tissue prominence ✔️ Vertical patella fractures are often inherently stable and can typically be managed conservatively ✔️ Intact retinacular expansions can sometimes allow a false-negative straight leg raise in a fractured patella 👩⚕️ WHO THIS IS FOR This masterclass is designed for orthopaedic surgical trainees, junior doctorsand medical students seeking a deep understanding of lower limb trauma. Curious patients looking to understand the biomechanics and surgical rationale behind kneecap fractures will also find it highly informative. 📚 RELATED TOPICS: Quadriceps and patellar tendon ruptures · Tension band principles in olecranon fractures · Bipartite patella differentiation · Total patellectomy consequences and rehabilitation · Patellofemoral joint biomechanics and contact forces · Cannulated screw fixation techniques in orthopaedics 🔗 More free orthopaedic teaching at Orthovellum.com — subscribe for weekly videos. 🎨 CREDITS • Original Orthovellum production. ⚠️ DISCLAIMER: Educational only — not individual medical advice. Always consult a qualified clinician for diagnosis and treatment. #orthopaedics #patellafracture #kneefracture #extensormechanism #tensionband #orthovellum #traumasurgery #kneebiomechanics #orthopedicsurgery #AOclassification #fracturefixation #medicaleducation #kneeinjury