Objective An inferior pole fracture of the patella requires surgical treatment to restore the knee extension mechanism of the knee joint. Different from other types of patellar fractures, inferior pole fractures are usually comminuted, and other traditional fixation methods, such as tension band wiring, may not meet the fixation needs. We propose fixing inferior pole fractures of the patella with a custom-made anchor-like plate combined with cerclage and report the surgical outcomes. Material and methods This is a retrospective clinical study. From June 2018 to August 2020, 21 patients with inferior patella fracture treated at Hong Hui Hospital Affiliated to Xi’an Jiaotong University received a custom-made anchor-like plate combined with cerclage. Complications of the surgical fixation methods and final knee function were used as the main outcome measures. Results All fractures achieved good union, and the union time ranged from 8 to 12 weeks. No patients had serious complications, such as internal fixation failure or infection. The average duration of surgery of patients was 75.05 7.26 min, and the intraoperative blood loss was 60.099.49 ml. At the last follow-up, the range of motion of the knee was 120°-140°, with an average of 131.436.92°, the Bostman score was 27–30, and the Lysholm score ranged from 82 to 95. All patients showed good knee function one year after the operation. Conclusion We used a modified T-shaped plate combined with cerclage technology to fix inferior fractures pole of the patella, providing reliable fixation, allowing early functional exercise of the knee joint, and providing patients with good knee joint function after surgery.

Objective To compare the clinical results of homemade hook plates and hollow lag screws combined with spacers in the treatment of posterior cruciate tibial ligament avulsion fractures. Materials and methods This was a retrospective clinical cohort study that included 64 patients with PCL tibial avulsion fractures. Thirty-two of them were fixed with a homemade hook plate (hook plate group), and 32 were fixed with a hollow lag screen combined with a gasket (hollow lag screen group). By reviewing the medical record data and follow-up results, the operation time, postoperative drainage, fracture healing time, surgical complications, knee mobility, recovery of joint function, and whether postoperative gastrocnemius muscle strength changed in the two groups were compared. Results All patients had successful wound and fracture healing. No adverse events, such as bone nonunion, infection, wound haematoma, or joint stiffness, occurred in either group. There were no patients with decreased gastrocnemius muscle strength in either group. Internal fixation failure occurred in 2 cases in the hollow lag screen group but not in the hook plate group. There were no significant differences between the two groups in terms of operative time, postoperative drainage, fracture healing time, knee mobility at the last follow-up, or Lysholm score. Conclusion It is safe and effective to use a homemade hook plate to fix PCL tibial avulsion fractures through an inverted L-shaped posterior medial approach. A homemade hook plate may have potential advantages over a hollow lag screen combined with gasket fixation.

Objective Fractures of the inferior pole of the patella can cause the knee joint extensor mechanism disorder. The fracture fragments are usually small and comminuted. Therefore, there are certain difficulties in fixation. The purpose of this study is to observe the effect of the "Net cage" technique in the treatment of the inferior pole of the patella. Methods This is a retrospective study that included 16 cases of inferior patella fractures (AO/OTA 34-A1) who underwent the "Net cage" technique from March 2017 to June 2020. Collecting their medical records and follow-up results, measuring indicators include the surgical complications of the fixation method, knee joint function, the number of fluoroscopies, fracture healing, and the incidence of soft tissue stimulation. Results The fractures of all patients healed smoothly, and there were no complications such as failure of internal fixation and fracture of implants. The average number of intraoperative fluoroscopy was 5.56 times (range: 4-10 times); the average fracture healing time was 10.5 weeks (range: 8-14 weeks) ). No patients reported internal fixation-related soft tissue irritation. At the last follow-up, the knee function showed that the average ROM was 133.75° (range: 120°~140°); The average Bostman score was 27.94 points (range: 24-30 points). Conclusion "Net cage" technology for the treatment of inferior pole fractures of the patella has the advantages of reduced fluoroscopy, fixation and stability, early functional exercise, and better knee joints after surgery.