Surgical Discussion

This is, in my opinion, the perfect indication for a locking plate with inferior pole hook extension. This secures both priary bony reconstruction, as well as engagement of the inferior pole and neutralisation of the major distracting force through the patella tendon. The hook itself, is however not alwasy sufficient, and i have a low threshold for suture augmentation of the locking plate fixation. Fibertape Krackow suture of both patella tendon and quadriceps tendon to the plate's peripheral sutures holes, this allows load transfer of quads tension over the plate into the patella tendon, minimising the likelihook of secondary displacement / avulsion. you may recognise that ive only utilised the proximal and distal holes of the plate, which have engaged good bone in their respective fragments and hold reduction. Also note i try to rediologically demonstrate a tangential shot accross both the medial and lateral facet surfaces to confirm extraarticular screw placement.

Orthopaedic implants used:   Arthrex patella suture-plate with inferior pole hook