A Modified Lag Screw and Cerclage Wire Technique for the Management of Sagittal Patellar Fractures: A Case Report

Sagittal patellar fractures account for a minority of patellar injuries and remain insufficiently represented in the orthopedic literature, particularly with respect to standardized operative fixation techniques. These fractures pose unique biomechanical challenges due to patellofemoral joint forces and the need to address both compressive and tensile stresses across the fracture site. We report the case of a 27-year-old man who sustained a displaced medial sagittal patellar fracture (AO/OTA 34B2.1) following a high-energy motor vehicle collision. Given the degree of articular displacement and comminution, surgical fixation was performed using a hybrid construct consisting of two 3.5 mm cannulated lag screws combined with a circumferential 1.25 mm cerclage wire. This technique provided stable interfragmentary compression while reinforcing the construct against distraction forces during knee flexion. Radiographic union was achieved by three months postoperatively, with restoration of full knee range of motion and no hardware-related complications. This case demonstrates that combining lag screw fixation with circumferential cerclage wiring offers a reproducible and biomechanically sound option for managing displaced sagittal patellar fractures, particularly in high-energy injury patterns where isolated fixation methods may be insufficient.