Plating of comminuted patellar fractures safe and viable treatment strategy

Because of the limited treatment options for treating comminuted patellar fractures, several surgeons have advocated for other treatment options. Recent work has suggested good clinical and functional results with dorsal surface plating of patellar fractures.

Jake X. Checketts et al conducted a study to calculate the reoperation rates for patellar fractures that had been treated with dorsal plating. The study was performed at Orthopaedic & Trauma Services of Oklahoma, Tulsa, Oklahoma. It has been published in JBJS Open Access.

This work consists of a retrospective review of clinical and functional outcome data following repair of patellar fractures with dorsal plates. The authors obtained institutional review board approval for this study and conducted a review of 9 consecutive years. They also contacted patients to assess patient-reported outcomes (PROs) after 12 months.

Key findings of the study were:

• Eighty-five patellar fractures were treated with open reduction and internal fixation (ORIF) via plating over 9 years.

• Eight (9.41%) of the patients required reoperation.

• Of the 72 patients with complete follow-up of >=12 weeks, 3 (4.17%) had nonunion of the fracture site and 4 (5.56%) had loss of reduction of the fracture.

• The average Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score among the sample was 18.84 (slight symptoms);

• 72.41% of the patients in the sample had slight or no symptoms at >=12 months postoperatively.

The authors concluded that – “Our results indicated that plating of comminuted patellar fractures is a safe, viable treatment strategy. The PROs at >=12 months of follow-up data were promising. Additionally, dorsal plating may allow for early return of function and less postoperative bracing.

Level of Evidence: Therapeutic Level IV. 

Key Words: JBJS Open Access, Jake X. Checketts, Reoperation, Patellar Fracture, Plate fixation

Further reading:

Reoperation and Complication Rates Following Patellar Fracture Repair with Plates, A Retrospective Analysis with Patient-Reported Outcomes at More than 1 Year of Follow-up, Jake X. Checketts, Jared Scott et al, JBJS Open Access 2022:e22.00012., http://dx.doi.org/10.2106/JBJS.OA.22.00012