Transverse patellar fracture fixation with tape cerclage in a patient with a history of complicated contralateral patellar fracture fixation with metallic hardware

Int J Burns Trauma. 2020 Dec 15;10(6):307-313. eCollection 2020.

Abstract

Patellar fractures are relatively uncommon; transverse displaced patellar fractures need surgical treatment, and the most widely used technique requires the use of metallic hardware. Despite good clinical outcomes, there are some possible complications related to the hardware. In this paper, we report a case of a 61 years-old woman that presented in 2001 with a fracture of the right patella that was treated with metallic hardware in another Hospital. After two months, the patient reported an infection of the hardware that became osteomyelitis, requiring several surgeries before achieving complete healing. The infection was eradicated, and the patient reached a good functionality of the right knee after two years from the first surgery. In 2019, she presented in our hospital with a displaced transverse fracture of the left patella. After a careful evaluation of the case, considering all the patient's comorbidities, allergies and the complications related to the previous treatment of the right patellar fracture, we decided to treat this fracture with non-metallic hardware (FiberTape Cerclage, Arthrex Inc., Naples, FL, USA). After surgery, the patient did not report any complications; the fracture was healed at the last x-ray follow-up (6 months), and the patient reached a good functional outcome of the left knee. Based on this case report, in this particular patient, the use of non-metallic hardware for patellar fracture fixation allowed us to obtain good results with no complications. However, this is only a case report, so the reliability of the proposed treatment cannot be directly concluded. Moreover, on the base of this case report, it is not possible to extrapolate the result in the routine treatment of patellar fractures.

Keywords: Patellar fractures; allergy; infection; metallic hardware; suture tape; symptomatic hardware.