A case report of inferior patella pole fracture fixation with sutures

Abstract

Introduction. The patella is the largest sesamoid bone in the human body, which is located in front of the knee joint and helps to protect it. The incidence of patellar fractures is 1% of all fractures. About 20% of surgically treated patellar fractures are located in the inferior patellar pole. These patellar fractures can be fixed with sutures or metal tension bend wire. The purpose of the case report is to present a case about internal fixation of inferior patellar pole fracture only with sutures. Case description. A 76-year-old female was administered to hospital with pain and swelling in her right knee after she fell directly on her knee. After X-Ray was performed inferior patellar pole fracture with displacement was diagnosed. Presurgical plan was made according to the patient’s age, sex and quality of the bone. After 5 days of hospitalization, an operation was performed under spinal anesthesia. A front incision was made in the knee joint, the fracture was exposed and the amount of bony fragments were evaluated. There was a decision made to perform three canals in patellar bone. Modified Krackow suture was performed in patellar tendon with 2 non-absorbable sutures. Threads then were passed through the created canals and continuously fixated a fracture to quadriceps tendon. Additionally, tendon defects were sutured by absorbable Vicryl sutures. The wound was irrigated and closed layer by layer. The leg was braced with an ability to correct an angle. First movements were allowed to perform after 2 weeks. After 8 weeks, full range of motion movement was successfully reached. Summary. Case report demonstrates successful fixation with sutures of patella inferior pole fracture. Conclusion. Traditional fixation methods are the best choice, but patient centric treatment might be optional accordingly.