Fixation of Comminuted Fracture of the Inferior Pole of the Patella Using Suture Anchors with Reinforcement by Ipsilateral Semitendinosus Tendon

Abstract

BACKGROUND: Many options have been used for treatment of comminuted fractures of the inferior pole of the patella as the ideal treatment has not yet been identified. The hypothesis was that fixation of these fractures using suture anchors with reinforcement by ipsilateral semitendinosus tendon will be rigid enough to allow early rehabilitation with good functional results with no need for further surgery for hardware removal.

METHODS: Ten patients (7 males and 3 females) with closed comminuted fractures of the infe-rior pole of patella were included in this study. Of the ten fractures, six resulted from a fall and four resulted from a car accident. The average age of patients was 31.6 years (range, 19 to 42 years). All patients were operated within 24 hours from the trauma. Fixation of fracture was done using suture anchors with reinforcement by ipsilateral semitendinosus tendon.

RESULTS: All fractures treated with this technique healed. All patients were followed-up for an average of 21 months (range, 13 to 30 months).Patients were evaluated according to the patellofemoral rating system. All patients were available for follow-up. The average patella femoral score was 94.7 points. The score was excellent for nine patients and good for one patient.

CONCLUSION: Fixation of comminuted fractures of the inferior pole of the patella using suture anchors with reinforcement by ipsilateral semitendinosus tendon left attached distally is rigid enough to allow early motion and shows good functional results. The technique is relatively sim-ple and feasible. Harvest of the tendon is easy with low donor site morbidity. No further surgery for hardware removal is necessary.