Morphological characteristics and a new classification system of the inferior pole fracture of the patella: A computer-tomography–based study

Use of metatarsal hook plates in the treatment of multifragmentary patellar fractures - A case series

“…The technique of cerclage and/or tension band has been traditionally employed to treat displaced fractures that had the capacity to withstand compression, with an intact opposite cortex and a fixation capable of supporting traction forces [ 14 , 16 , 18 , 23 ]. However, in the case of multi-fragmentary fractures that did not meet these requirements, unfavorable results have been reported when using this fixation method [ 7 ]. Bostman et al [ 28 ] described that as the fracture became multi-fragmentary and the patient's age increased, results with cerclage and/or tension band tended to deteriorate.…”

“…Given the absence of a suitable classification for lower pole patellar fractures, Liu et al [ 7 ] proposed a classification based on the morphological characteristics of the fracture. This approach, developed after studying CT images in 71 patients, allows for the determination of an individualized treatment protocol for each type of fracture.…”

“…CT had a greater capacity to delineate or evaluate fracture patterns, determine the number of fragments, and assist in choosing the most appropriate osteosynthesis. The morphology of fractures of the inferior pole of the patella, for example, was identified in 88% through CT, while plain radiographs only managed to identify 44% of cases [ 7 ].…”