Functional Outcome of Extensor Mechanism Salvage in Patella Fracture Non-union Using Krackow Sutures: A Case Report

Patellar fractures can lead to extensor mechanism dysfunction if not repaired properly, impacting knee function and mobility, and this complication can be challenging to manage, especially in cases where previous surgical interventions have failed. The aim of this study was to evaluate the functional outcome of the salvaged extensor mechanism in patella fracture non-union using Krakow sutures in a 61-year-old female patient who presented with knee pain, reduced flexion, and a 40-degree extension lag after two previous patellar fracture surgeries using tension band wiring resulted in non-union. Despite rehabilitation attempts, her knee function remained compromised. Krakow suturing was performed to reinforce the patellar and quadriceps tendons, ensuring a secure extensor mechanism. This procedure provided a strong and reliable repair, even in compromised tissue. Post-surgery, successful salvage of the extensor mechanism was achieved, with improved knee function and mobility, significant improvement in Lysholm scores and Tegner activity levels, and 80% restoration of quadriceps strength compared to the contralateral side. This case demonstrates that Krakow suturing can be an effective salvage procedure for extensor mechanism dysfunction in patellar non-union, even in previously operated cases, restoring knee function and mobility.