Treatment Of Patellar Fractures Research Articles

Tension band versus locking plate fixation for patella fractures - a protocol of a randomised controlled trial.

Following surgical management of patella fractures, patients commonly report pain; difficulties with weight-bearing tasks such as walking, running and climbing stairs; and restrictions in quality of life. Recently, a locking plate system for surgical management of patella fractures has been introduced. To date, no studies have compared standard treatment with tension band wiring with locking plate fixation in a randomised study design. We aim to compare the one-year patient-reported Knee Injury and Osteoarthritis Outcome subscale scores (KOOS5-subscales) after standard care tension band fixation with locking plate fixation for patients with patella fractures. This is a multicentre randomised and prospective clinical trial. A total of 122 patients will be included in the study, and the primary outcome will be the KOOS subscales at 12 months after surgery. Findings from the present study are expected to advance our understanding of outcome following surgical treatment of patella fractures. This study is funded, in part, by the Novo Nordisk Foundation, Denmark. gov ID: NCT04891549.

Outcomes of treatment of patella fractures in children and adolescents

Purpose: The purpose of this study is to assess clinical and functional outcomes in separate cohorts of operatively and nonoperatively managed pediatric patella fractures. Methods: A retrospective review was completed for patients aged 5–19 years treated for a unilateral patella fracture at a single pediatric level-1 trauma center. Patients were excluded for osteochondral fracture associated with patellar dislocation, polytrauma presentation with additional fractures, or <3 months of clinical follow-up. Functional outcomes were assessed via the Pediatric International Knee Documentation Committee form and the Marx Knee Activity Scale. Results: A total of 53 patients met inclusion criteria; 30 patients were treated operatively and 23 patients were treated nonoperatively. Patients with patellar sleeve/pole fractures were significantly younger by 5.2 years (p < 0.01) and presented with greater variability in mechanism of injury (p < 0.01). The nonoperative cohort achieved bony healing and returned to sports at a median (interquartile range) of 1.7 (1.2–2.3) months and 2.8 (2.3–3.3) months, respectively, post-injury. The operative group achieved bony healing and returned to sports at 2.8 (2.1–3.5) months and 5.9 (4.0–7.1) months, respectively, following surgery. Median (interquartile range) Pediatric International Knee Documentation Committee and Marx scores were 98 (89–100) and 14 (10–16), respectively, for the nonoperative group, and 92 (84–99) and 13 (12–16), respectively, for the operative group. No significant differences in patient-reported outcomes were observed between fracture patterns or treatment cohorts. Conclusion: Pediatric and adolescent patients sustaining patella fractures reported long-term functional outcomes comparable to normative values, across multiple fracture patterns and with appropriate operative and nonoperative treatment. Fractures requiring surgery were expectedly associated with slower healing and return to sport timelines. Level of evidence: Therapeutic Level III.

High risk of complications following surgical treatment of patella fractures - a cross-sectional study of 798 patients with mean 6.4years follow-up.

This study aimed to investigate the incidence of early and late complications following treatment of patella fractures. Secondary aims were to investigate the association between early and late complications and the patient-reported outcome measurement, the Knee Injury and Osteoarthritis outcome score (KOOS). Cross-sectional study including all patients recorded with a patella fracture residing in the Northern Region of Denmark between 2010 and 2020. Early (before 3months) and late complications were investigated by retrospective review of charts and x-rays. All patients were invited to participate in the study by reporting current knee-specific symptoms. The KOOS was used to investigate patient-reported knee-specific symptoms. Seven hundred ninety-eight patients were included in the study. A total of 532 (67%) patients were treated conservatively, and 266 (33%) patients underwent surgery. The mean age at the time of fracture was 66.8, ranging from 6 to 103years of age. The mean follow-up time was 6.4years, ranging from 1.1 to 12.3years follow-up. Overall, the rate of complications was 26%. Overall, the rate of complication for the surgical group was 57% and for the conservative group 4%. The most common early complication was the loss of reduction followed by the removal of symptomatic hardware. The most common late complication was the removal of symptomatic hardware and knee arthroscopy. In all the five KOOS subscales (Pain, Symptoms, ADL, Sport/Rec, and QOL), patients presenting with early and late complications reported statistically significantly worse scores than those without complications. The overall incidence of complications in patients presenting with a patella fracture was 26%, with a mean follow-up time of 6.4years. In the surgical group, 57% of patients experience at least one complication during the follow-up period. Early and late complications were significantly associated with worse KOOS subscale scores.

PATELLA FRACTURES IN THE FRAIL HOST: A SYSTEMATIC REVIEW

AbstractObjectivesThe outcomes from patella fracture have remained dissatisfactory despite advances in treatment, especially from operative fixation1. Frequently, reoperation is required following open reduction and internal fixation (ORIF) of the patella due to prominent hardware since the standard technique for patella ORIF is tension band wiring (TBW) which inevitably leaves a bulky knot and irritates soft tissue given the patella's superficial position2. We performed a systematic review to determine the optimal treatment of patella fractures in the poor host.MethodsThree databases (EMBASE/Medline, ProQuest and PubMed) and one register (Cochrane CENTRAL) were searched. 476 records were identified and duplicates removed. 88 records progressed to abstract screening and 73 were excluded. Following review of complete references, 8 studies were deemed eligibleResultsComplication rates were shown to be high in our systematic review. Over one-fifth of patients require re-operation, predominantly for removal of symptomatic for failed hardware. Average infection rate was 11.95% which is higher than rates reported in the literature for better hosts. Nevertheless, reported mortality was low at 0.8% and thromboembolic events only occurred in 2% of patients. Average range of movement achieved following operative fixation was approximately 124 degrees. Upon further literature review, novel non-operative treatment options have shown acceptable results in low-demand patients, including abandoning weight-bearing restrictions altogether and non-operatively treating patients with fracture gaps greater than 1cm. Regarding operative management, suture/cable TBW has been investigated as a viable option with good results in recent years since the materials used show comparable biomechanics to stainless steel. Additionally, ORIF with locking plates have shown favourable results and have enabled aggressive post-operative rehabilitation protocols. TBW with metallic implants has shown higher complication rates, especially for anterior knee pain, reoperation and poor functional outcomes.ConclusionThere is sparse literature regarding patella fracture in the poor host. Nevertheless, it is clear that ORIF produces better outcomes than conservative treatment but the optimal technique for patella ORIF remains unclear. TBW with metallic implants should not remain the standard technique for ORIF; low-profile plates of suture TBW are more attractive solutions. Non-operative treatment may be considered for low-demand individuals however any form of patellectomy should be avoided if possible.Declaration of Interest(b) declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported:I declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

High return to sports rates after operative treatment of patella fractures

BackgroundPatella fractures are relatively rare fractures and only little is known about the postoperative return to sports after patella fractures.MethodsThis retrospective study presents information on functional outcome after operative treatment of patella fractures as well as time until return to sports and patients’ complaints after open-reduction internal-fixation (ORIF) of patella fractures.ResultsOverall, 39 patients after ORIF of patella fractures were evaluated at our Level-I trauma center with a mean follow-up of 42 months. The mean time until return to sports was 7 ± 3.9 months. No significant difference was found for functional outcome with respect to body mass index (BMI) or age. Fracture consolidation was accomplished after a mean of 6.9 ± 2.9 months besides a relatively low complication rate of 5.1% (n = 2).ConclusionThe results demonstrate a high return to sports rate of 90.3%. However, only 51.6% were able to perform sports on their pre-injury level or above.Trial Registration The study was retrospectively registered at DRKS (No: DRKS00031146).

Management of patella fracture with percutaneous wiring

Patella fractures are fixed traditionally in orthopaedics by open reduction and internal fixation as it is an intra-articular fracture. Open operative techniques are associated with high incidence of infections, cosmetic problems, and delayed rehabilitation. Percutaneous, arthroscopic techniques have fewer complications but these are technically demanding procedures to master. Percutaneous wiring of patella being a newer technique, in our study of 25 patients we evaluated its results over other conventional methods of treatment of patella fracture. The patients were followed up for 30 months and its results were studied.

Observation of the effect of arthroscopically assisted percutaneous minimally invasive Kirschner wire tension band fixation on the treatment of patellar fractures.

Patellar fractures are common intra-articular fractures. Arthroscopically assisted reduction and fixation has been shown to advantageous in the treatment of patellar fractures. This study aimed to investigate the effect of arthroscopically assisted percutaneous minimally invasive Kirschner wire tension band fixation on the treatment of patellar fractures. Thirty-four patients with acute closed patellar fractures enrolled in the study and were managed by arthroscopically assisted percutaneous minimally invasive Kirschner wire tension band fixation under epidural anesthesia. Among these patients, 24 were males, and ten were females. The mean age of these patients was 38 ± 0.8 years (range: 25-62 years). Of these patients, 20 had transverse fractures, five had longitudinal fractures, four had marginal oblique fractures, and five had multifragmentary upper and lower pole. Fracture causes: 25 were caused by falls, and nine were caused by traffic accidents. The time from injury to operation was 6-48 hours, with an average of 23 hours. The average post-operative follow-up was 12.8 months, and at the end of follow-up, the Boestman scoring system was used to evaluate knee joint function. All the wounds healed by first intention, and no infections, skin necrosis, joint stiffness, or other complications occurred. Three months after operation, the tension band wire had broken in one patient, but the fracture had united, and this did not affect the prognosis. In eight patients, the average circumference at 10 cm above the patella was 0.6 cm less on the injured side than on the contralateral side. The average Boestman score was 27.5. The final result was excellent in 25 patients, good in eight patients, and acceptable in one patient. Arthroscopic management of simple patellar fracture with percutaneous minimally invasive Kirschner wire tension band fixation is less invasive than open operation, while still leading to firm fixation, and is conducive to early functional training and functional recovery, and thus is an effective method of management for patellar fractures.

Evaluation of the Surgical Treatment of Patella Fractures in 17 Cases in the Orthopedic-Traumatology Department of the University Hospital Center of Donka, Republic of Guinea

Evaluation of the Surgical Treatment of Patella Fractures in 17 Cases in the Orthopedic-Traumatology Department of the University Hospital Center of Donka, Republic of Guinea

Fixation of patella fractures with metallic implants is associated with a significantly higher risk of complications and re-operations than non-metallic implants: a systematic review and meta-analysis.

The use of metallic implants for the treatment of patella fractures often involves complications related to the hardware. As a result, there has been a considerable focus on the use of non-metallic implants. The aim of this study was to determine the differences in clinical outcomes, including the rates of complications and re-operations following the surgical management of patellar fractures with metallic versus non-metallic implants. The systematic review was conducted in accordance with PRISMA guidelines. Two investigators independently applied the search strategy to PubMed, SCOPUS, Google Scholar, and Cochrane databases, limited to publications between 1st January 2000 to 30st September 2021. The search strategy identified studies in which there was a comparison between the clinical outcome of the metallic and non-metallic fixation. Meta-analysis was conducted according to the Cochrane Collaboration and Quality of Reporting of Meta-Analysis (QUORUM) guidelines. A total of 19 studies were selected for the systematic review and seven studies for the meta-analysis. Two hundred ninety-sixt patients formed the pooled study population for the meta-analysis. The outcomes evaluated in the meta-analysis were range of motion (ROM), complications, and re-operation rates. There was no significant difference between groups regarding ROM, but the risk ratio (RR) of re-operation (RR 0.19, 95% CI [0.09-0.41]) and complications (RR 0.30, 95% CI [0.17-0.55]) was significantly in favor of fixation with non-metallic implants. The use of non-metallic implants for fixation of patella fractures was associated with significantly lower risk of complications and re-operations than fixation with metallic implants, without any difference between groups with respect to the final range of motion or functional outcome measures.

Epidemiology, classification and treatment of patella fractures: an observational study of 3194 fractures from the Swedish Fracture Register

BackgroundBasic epidemiological data on patella fractures derived from large nationwide and multicenter studies are scarce. This observational register study describes patient epidemiology, fracture classification and treatment of patella fractures in adults in a Swedish population.MethodsWe conducted an observational study on data derived from the Swedish Fracture Register (SFR) on all patella fractures classified as non-periprosthetic and non-pathological, registered between 2014 and 2018 in individuals aged ≥ 18years. Epidemiological data on sex, age, side, seasonal variation, trauma mechanism, fracture classification (according to AO/OTA), and treatment were analyzed.Results3194 patella fractures were analyzed, occurring at a median age of 67 (range 19–100) years. 64% of all patients were female. Most fractures were caused by low-energy trauma, with 70% due to falling from a standing height. 1796 (56%) of the fractures were transverse compared to 845 (26%) vertical fractures. Most fractures (N=2148, 67%) were treated non-operatively. Operative treatment consisted mainly of Tension Band Wiring (TBW) performed in 774 (24%) patients.ConclusionsPatella fractures mainly occur in elderly women (> 65 years), commonly caused by low-energy trauma. The main treatment is non-operative (67%), except for transverse (AO/OTA C3) fractures. TBW remains the most used operative treatment of choice. These results may help health care providers, researchers and clinicians better understand the panorama of patella fractures in Sweden.

Wandel in der Behandlung der Patellafrakturen

Fractures of the patella can lead to substantial functional impairments due to its crucial function in the extensor mechanism of the knee joint. Patellar fractures are associated with acomparatively high complication rate depending on the osteosynthesis procedure used. Despite established diagnostics and various osteosynthesis procedures they are still atherapeutic challenge. This article gives an overview of the change in the treatment of patellar fractures and highlights the importance of comprehensive diagnostics and fracture-adapted treatment, especially for the increasing fractures in old age. Evaluation of the current literature, discussion of biomechanical and clinical studies and expert recommendations (guidelines) RESULTS: Tension band wiring is still the most commonly used procedure; however, it is associated with ahigh rate of implant-related complications and failure rates. In particular, multifragmented comminuted fractures can often not be adequately treated by tension band wiring. Anterior locking plates seem to be biomechanically and clinically superior. For agood functional result after apatellar fracture, the fracture morphology must be completely understood and the optimal choice of the osteosynthesis method is crucial. Distal (or proximal) pole fractures and the increasing number of osteoporotic fractures of old patients due to the demographic change, remain atherapeutic challenge and require special consideration in the selection of the osteosynthesis procedure.

Mechanical Analysis and Clinical Application of Butterfly-Shaped Patellar Claw.

Memory alloy patella claws for treating patella fractures have been used for more than 30 years with many desirable features including fast healing, quick recovery, and avoidance of top abrasion of Kirschner wires and other complications. However, there are many models and it is difficult to choose the accurate claw for the patient. In this study, a finite element model of the butterfly-shaped patellar claw made of shape memory alloy was established, its mechanical structure was analyzed, and its clinical application was monitored. We used Solidworks Simulation software for modeling and mainly analyzed the force of the compression ring of the butterfly-shaped patellar claw. Clinically, we chose a closed fresh patella fracture case. After finite element analysis, the maximum stress that the compression ring of the butterfly-shaped patellar claw can withstand is 568.1 MPa. In this range, it always has elastic deformation resistance. The butterfly-shaped patella claw is fixed on the patella and will not break when subjected to a maximum force of 150 N on the encircling arm, and at the same time, there will be no pressure failure due to plastic deformation. A total of 27 cases were clinically used for the assessment of the clinical efficacy of the newly designed butterfly-shaped patella claws. The average follow-up time was 15.5 months, and the average fracture healing time was 8-12 weeks. All patients can get out of bed with crutches within 2 to 3 days after surgery. Among them, there were 15 cases with excellent functional ratings, 10 cases with good ratings, 2 cases with acceptable ratings, and no cases with poor ratings. The designed butterfly-shaped patella claws can provide an effective method for the treatment of patella fractures.

Comparison of the Clinical Effect of Hollow Lag Screw Internal Fixation and Kirschner Wire Tension Band in the Treatment of Patella Fracture and Knee Joint Recovery Rate

Comparison of the Clinical Effect of Hollow Lag Screw Internal Fixation and Kirschner Wire Tension Band in the Treatment of Patella Fracture and Knee Joint Recovery Rate

Functional Outcome of “Reconstruction Patellar Plate” in the treatment of patella fractures

Background: The patellar fractures treatment has changed by enhancements in both an improved understanding of patellar function and fracture fixation techniques. The goals of operative fixation include repair of extensor mechanism, restoration of articular congruity, secure fixation and early movements. In this Study Reconstruction patellar plate was introduced in the management of patellar fracture. Aim: To determine the Functional outcome of fixation method of patella fractures by Open Reduction and Internal Fixation with Reconstruction Patellar Plate. Methods: This Prospective study was performed at Department of Orthopaedic Surgery at Lahore General Hospital for a period of 12 months after the approval Research Board of University of health Sciences, Lahore. Non probability purposive sampling method was used to induct 30 patients (who met the inclusive Criteria) underwent reconstruction patellar plate for the treatment of patella fracture. The patients were followed in outpatient department at 4 weeks and 16 weeks. Variables mentioned in Modified Hospital for Special Surgery Knee Score were recorded and Knee score was calculated and graded at 16 weeks. Results: In this study, overall mean age was 25.26 ± 5.02 years. There were 19 (63%) male and 11 (37%) female subjects. The mean of Modified Hospital for Special Surgery Knee Score (MHSSKS) was 84.90±8.87. In this study, there were 12(40%) patients with excellent functional outcome, 14 (46.67%) patients with good functional outcome and 4(13.34%) patients with fair functional outcome. There was no patient with poor functional outcome. Conclusion: Reconstruction Patellar Plate fixation method of patella fractures by Open Reduction and Internal Fixation produced good Functional outcome, which can be familiarized as an alternate to tension band method for the treatment of transverse patellar fracture. Keywords: fracture, patellar, reconstruction patellar plate, tension Band wiring

Functional outcome of surgical management in cases of fracture patella in a tertiary care hospital in Salem

<p><strong>Background: </strong>Fractures of the patella are serious injuries with a broad range of subtypes. These injuries account for about 1% of all skeletal injuries and are most prevalent within the age group of 20-50 years. The underlying mechanisms of open fractures are mostly high-velocity accidents. To assess the functional outcome of various surgical procedures done for fracture patella.</p><p><strong>Methods: </strong>A longitudinal study was conducted from the department of orthopedics, Vinayaka missions Kirupananda Variyar medical college and hospital, Salem for one year in August 2019 and July 2020. All the adult patients admitted with the diagnosis of patellar fracture were included in the study. A complete local examination was conducted and an X-ray of AP and the lateral view was taken for all the patients.</p><p><strong>Results: </strong>Transverse patella fracture is being the most common fracture and for that modified tension band wiring (TBW) was the most common procedure performed and for comminuted fracture partial patellectomy was the most common procedure and for 1 patient total patellectomy was performed.</p><p><strong>Conclusions:</strong><strong> </strong>The study shows that the treatment of patella fractures with modified tension band wiring is a definitive treatment with minimal complications and excellent functional outcomes.</p>

FRACTURAS COMPLEJAS DE RÓTULA:¿OSTEOSÍNTESIS CON BANDA DE TENSIÓN O PLACA BLOQUEADA?

The gold Standard in the treatment of patella fractures is generally the tension band technique.Recently, the treatment of these fractures by means of plate osteosyntehsis has been implemented, obtaining good results, and a low rate of complications and reinterventions. GOAL: Evaluate the clinic, functional and radiologic results in patients with a complex patella fracture, comparing results of plate osteosynthesis treatment versus tension band. MATERIAL AND METHODOLOGY:Retrospective obvervational cohort study. A total of sixty patients with patella fracture were evaluated at Hospital General Universitario de Elche between 2015 and 2020, thirty by tension bands technique and the other thirty with plate osteosynthesis treatment. All the clinic, functional and radiologic results, as well as complication were registered and compared for both groups. RESULTS: The functional scales show no differences (LES p = 0.475, EVA p = 0.888, KOS-ADLS p = 0.327). Differences have been found (p <0.001) in relation to the extraction of osteosynthesis material (EMO) in patients operated on with BT (50% vs 0%). We identified more material failure in BT (37.5%) versus 0% in plate (p = 0.001). The flexion ranges were higher in the plate group (120.42º) compared to BT (110º) without statistically significant differences. There are no differences in relation to scarring, infection, stiffness, pseudoarthrosis, patella magna or low, loss of reduction or deep vein thrombosis. CONCLUSIONS: All the patients with patella fracture that were evaluated presented successful clinic and functional results. However, we found a lower rate of complication and reinterventions on the plate osteosynthesis treatment. In summary, it has been proved that plate osteosynthesis treatment is a successful holding method for complex patella fractures.

Treatment of patellar fractures using bioresorbable forged composites of raw particulate unsintered hydroxyapatite/poly-L-lactide cannulated screws and nonabsorbable sutures

Forged composites of raw particulate unsintered hydroxyapatite/poly-L-lactide (F-u-HA/PLLA) implants are widely used in surgeries because they possess high mechanical strength, bioactivity, and radio-opacity. We previously reported that F-u-HA/PLLA implants were useful for treating lateral tibial condylar, lateral humeral condylar, and ankle fractures. The study aim was to investigate the efficacy of F-u-HA/PLLA cannulated screws and FiberLoop® for treating transverse patellar fractures. From April 2013 to February 2019, 15 patients with transverse patellar fractures were treated with F-u-HA/PLLA cannulated screws and FiberLoop® as follows: Open reduction and internal fixation (ORIF) were performed with two F-u-HA/PLLA cannulated screws and a temporary fixation Kirshner wire (K-wire). Three No. 2 FiberLoops® were inserted into these two screw holes and the K-wire hole for temporary fixation. All patients were allowed to full weight-bearing gaits using a knee brace. Knee range of motion exercise was initiated on postoperative day 1. Knee flexion was restricted to ≤90° for 1 month postoperatively. Radiograph was performed to evaluate fracture healing, screw breakage, reduction loss, and screw radio-opacity. Clinical outcomes and postoperative complications were assessed. The average follow-up was 16.0 months. All fractures were successfully united. Screw breakage, reduction loss, osteolysis, and radiolucent zones around the screws were not observed at the final radiographic follow-up. All F-u-HA/PLLA screw shadows were observed during the follow-up. The average range of flexion and extension were 132.0° and -2.7°, respectively. No patients experienced deep infection episodes, late aseptic tissue reactions, or foreign body reactions postoperatively. No patients complained of pain at the final follow-up. All patients returned to their pre-injury work level and activities of daily living. Our results strongly suggest that ORIF with F-u-HA/PLLA screws and FiberLoop® could be an alternative treatment option for transverse patellar fractures.

Results of surgical treatment of patella fractures

Results of surgical treatment of patella fractures

A comparison of EFECE systems with tension band wiring for patella fracture fixation in cadavers

BackgroundEFECE systems are newly defined internal fixation systems, which are suitable for patella fracture fixation. The aim of this study was to compare the fixation strength of EFECE Systems with tension band wiring for transverse patellar fracture simulation on fresh frozen cadaver models.MethodsQuadriceps tendon-patella-patellar tendon (QT-P-PT) complex was prepared from human cadavers. After simulation of a transverse patella fracture, in group 1, 5 patella were fixed with a pair of 1.2 mm EFECE wires and 4 EFECE devices. In group 2, 5 patella were fixed with a pair of 1.2 mm Kirschner wires (K-wire) and a cerclage wire according to the tension band technique.Using a testing device with custom-made jaws, increasing distraction force was applied to these QT-P-PT complexes. Extension of these complexes with the distraction forces was observed. The maximum distraction force and the elongation during maximum force were evaluated.ResultsAfter 5 experiments with the EFECE systems, there was no EFECE wire breakage or EFECE wire-EFECE device catching failure. The median maximum force was 740 N (720-810 N). During maximum distraction force the median extension was 2.5 mm (1.6-2.5 mm). After 5 experiments with the tension band technique, there was no K-wire breakage. The median maximum force was 330 N (240-510 N). During this maximum distraction force the median extension was 3.4 mm (2.2-3.8 mm).ConclusionsBased on the biomechanical advantages, patella fracture treatment with EFECE systems may constitute a reasonable alternative in the treatment of patella fractures.

Результаты хирургического лечения переломов надколенника

Introduction Patella fractures account for one percent of all fractures. Arthritis, non-union and other complications which affect the function of the lower limb may develop in the long term. The aim was to develop the most optimal osteosynthesis techniques for patella fractures. Methods We analyzed longterm treatment results of 78 patients with patella fractures treated from 2017 to 2018 using the KOOS (The Knee Injury and Osteoarthritis Outcome Score) scale, clinical examinations and knee joint X-rays. Based on the methods of surgical treatment for patella fractures, we divided the patients into 5 groups: Weber tension band wiring for two-fragment fractures; cross-like osteosynthesis and other methods of patella osteosynthesis using K-wires and wire loops for multifragmental fractures of the patella; combined osteosynthesis (tension band wiring with an additional screw or cerclage around patella); partial patellectomy and the inferior pole osteosynthesis. Results A comparative analysis of patients’ groups after surgical treatment of patella fractures using the KOOS scale showed the best results after Weber tension band wiring for transversal fractures (72 %). The results of patients with multifragmental fractures of the patella using K-wires and wire loops were positive in 64 %; after the restoration of the inferior pole in 68 %, after partial patellectomy in 57 %. Conclusion For transversal fractures of the patella, tension band wiring is the method of choice. With multifragmental patella fractures, good results are achieved by cross-like osteosynthesis and other methods using K-wires and wire bands. The use of patellectomy followed by wire loop locking should be avoided for all types of patella fractures. In fractures of the inferior pole of the patella, it is preferable to fix it to the main patella fragment.