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Three Part Question

In [adult patients with uncomplicated patellar fracture] is [a plaster cylinder compared to a cricket pad splint] better at [reducing symptoms/speeding up functional recovery]?

Clinical Scenario

A 32 year old man presents to the Emergency Department having landed on his knee whilst playing football. His x-ray reveals a closed vertical fracture of his patella. You wonder if a cricket pad splint is as good as a plaster cylinder for immobilisation.

Search Strategy

Medline using the Ovid interface (1950 – 2010)
Embase (1980 - 2009)
Cochrane (the whole database)


Medline:{patella$.mp} AND {exp fractures, bone OR exp fractures, closed OR fracture healing OR fract$.mp exp } LIMIT to human, English language and therapy (sensitivity).

Embase:(Exp patella OR exp patella fracture) AND (exp splint OR plaster cast)

Cochrane: Search using the term “patella”

Search Outcome

237 papers were found using the OVID interface, 20 with Embase, no yield within the Cochrane Library. None of the papers found were relevant to the original question.

Comment(s)

This is a real life clinical scenario. In patients with uncomplicated fracture of the patella, minimal symptoms and no instability, one would have thought that a cricket pad splint would offer as much biomechanical stability as a plaster cylinder. Unfortunately, there do not seem to be any studies available to date to support this theory.

Clinical Bottom Line

There is no published evidence. Local advice and guidelines should be followed.