The question as to the operative versus the mechanical treatment of fracture of the patella has been ably discussed in a number of papers in the last few years. Some of these have been read before this Association.
I do not intend to reopen this discussion, inasmuch as my contribution deals only with a detail in the technic of the open operation; yet it is only fair that, in order that I may not be misunderstood, I should state my position in the matter; the more so, since the principle of my technic is closely linked with the reasons for my views in regard to the treatment in general.
Fractures of the patella are divisible into two classes—those caused by direct and those caused by indirect violence. Or, as von Mikulicz1 has very aptly put it, "blow" and "tear" fractures. To this classification he also added another which was the
BLAKE JA. TREATMENT OF FRACTURES OF THE PATELLA BY LATERAL SUTURES. JAMA. 1904;XLIII(14):962–966. doi:10.1001/jama.1904.92500140001h
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