A Novel Technique for the Treatment of Inferior Pole Fractures of the Patella: A Preliminary Report

Orthop Surg. 2022 Nov;14(11):3092-3099. doi: 10.1111/os.13518. Epub 2022 Oct 4.

Abstract

Objective: Most inferior pole fractures of the patella are comminuted. Therefore, an ideal treatment method has not been determined. We have presented a modified tension band fixation technique-the Krachow suturing, Nice knot combined with tension band fixation-and reported the results of the procedure.

Methods: A total of 16 inferior patellar pole fractures were treated at our institution between January 2019 and October 2020, 15 of which underwent treatment with the modified tension band fixation technique consisting of Krachow suturing with Nice knots combined with tension band fixation. The primary measures: knee motion, Bostman score, anterior knee pain, fixation failure.

Results: Bone union occurred at a mean of 9 weeks postoperatively (range: 8-13). There were no cases of postoperative anterior knee pain, refracture of the inferior patellar pole or wire breakage. The patients regained full ROM of the knee joint without functional deficits during follow-up; the mean ROM was 128.46° ± 7.07° (range: 113.4°-137.8°). At the last follow-up, all patients had a mean Bostman score of 28.40 ± 1.29 (range: 26-30), with an excellent score in 11 patients and a good score in four patients.

Conclusion: The modified tension band fixation technique for the treatment of inferior patellar pole fractures is a simple and easy-to-perform surgical technique that provides stable fixation and good functional results.

Keywords: Krackow suture; Nice knots; fracture; inferior pole; patellar.

MeSH terms

  • Bone Wires
  • Fracture Fixation, Internal / methods
  • Fractures, Bone* / surgery
  • Fractures, Comminuted* / surgery
  • Humans
  • Pain
  • Patella / surgery
  • Retrospective Studies
  • Treatment Outcome