Suture Augmentation of Internal Fixation for Highly Comminuted Patella Fractures

Treatment of comminuted patella fractures is challenging. Augmentation of internal fixation has been proposed to improve stability. The authors describe an effective technique to augment internal fixation consisting of locked sutures within the quadriceps and patellar tendons. This technique functions to off-load internal fixation and restore tension to the extensor mechanism. The locked suture augmentation technique was performed for 13 patients undergoing open treatment of patella fractures by the senior author from 2016 to 2019. Patients were followed for an average of 10.2 months. No patients suffered postoperative infection or wound complication requiring intervention. There were no cases of fracture displacement, implant failure, loss of fixation, postoperative infection, or wound complication requiring intervention. Mean range of motion was 0 - 134 degrees of extension, and no patients demonstrated an extensor lag. The authors conclude that locked suture augmentation of comminuted patella fractures represents a viable technique that demonstrates excellent early clinical results. (Journal of Surgical Orthopaedic Advances 33(4):201-205, 2024).