Arthroscopic-assisted surgical technique for treating patella fractures

The purpose of this study was to describe and report preliminary results of an arthroscopic-assisted surgical technique for the treatment of displaced transverse patella fractures with percutaneous internal fixation. We applied this technique in 5 patients who presented a displaced transverse patella fracture and were followed-up for an average of 18 months. Under an image-intensifier fluoroscope, the fracture was closely reduced with a percutaneously reduction clamp while the congruence of the articular surface was monitored arthroscopically. Two Kirschner wires were inserted perpendicular to the fracture line followed by 2 cannulated lag screws obtaining interfragmentary compression. By using a cannulated guide, 2 wires were threaded through both cannulated screws and percutaneously were crossed over the top of the patella creating a figure-8 pattern tension band. At final follow-up, radiographic consolidation was achieved in all patients obtaining full range of motion and returning to the activity level previous to the fracture. Arthroscopic internal fixation is a valid alternative for the treatment of intra-articular displaced and noncomminuted patella fractures. This technique allows healing of the fracture with low patient morbidity, a short hospitalization period, and an accelerated rehabilitation of the affected knee.