Plating of Patella Fractures: A Novel Technique Using Multiplanar Fixation

Fractures of the patella present unique challenges to surgeons and patients alike. As surgical knowledge and technique has advanced, management of these injuries has evolved from nonoperative care or patellectomy to anatomical reduction and internal fixation. Currently, tension band constructs are the most common method of fixation, but anterior knee pain and implant-related problems have become accepted as an expected consequence of treatment. Further, this technique often fails to address inferior pole comminution commonly seen in these injuries. In an effort to improve clinical outcomes and patient satisfaction, patella fracture plating has increased in popularity, but operative plating techniques vary significantly. In this article, we describe a novel treatment strategy that permits direct visualization of the articular reduction, uses multiplanar fixation through a low-profile small-fragment mesh plate, and addresses inferior pole comminution with minimal disruption to the patella vascularity. (C) 2015 Elsevier Inc. All rights reserved.