Suture Anchor Fixation for Inferior Pole Patellar Fractures

Suture anchor fixation for inferior pole patellar fractures is a minimally invasive surgical method suitable for small fracture fragments that are difficult to stabilize using traditional plates or screws.

The core of the technique involves implanting anchors combined with high-strength sutures to reconstruct the attachment point of the patellar ligament to the fracture fragment, thereby restoring joint stability. The procedure requires precise fracture reduction, proper anchor selection, and emphasis on postoperative rehabilitation exercises to reduce the risk of joint stiffness.

Indications and Principle

Inferior pole patellar fractures are often caused by direct trauma or sudden, forceful contraction of the quadriceps. Due to the small size of the fracture fragment and its proximity to the patellar ligament insertion point, conventional internal fixation methods may fail.

Anchor fixation is particularly suitable for small fragments (<1.5 cm) or comminuted fractures. Anchors secure the sutures to the patellar ligament, and ligament tension helps maintain fracture reduction, minimizing the risk of secondary injury.

Surgical Procedure and Key Steps

1. Positioning and Exposure

The patient is placed in a supine position with the knee flexed at 30°. A longitudinal or transverse incision is made anterior to the patella to expose the fracture site and the insertion of the patellar ligament.

2. Fracture Reduction

After clearing the hematoma, use point reduction forceps or Kirschner wires to temporarily fix the fracture fragment. Ensure the articular surface is smooth and confirm alignment with C-arm fluoroscopy.

3. Anchor Insertion

Drill a hole in the bone bed proximal to the fracture fragment and insert a suture anchor. The anchor should be placed perpendicular to the bone surface and deep enough to reach the subcortical bone.

4. Suture Fixation

Pass the anchor sutures through the patellar ligament in a figure-of-eight or Krackow stitch pattern. Tighten and tie the sutures to secure the ligament against the fracture fragment. Additional anchors or Kirschner wires may be used for supplemental fixation if needed.

5. Wound Closure

Close the incision in layers. Place a drain if necessary and apply a compression dressing.

Postoperative Images

Atom Product:

Type I :  4.5 × 14 mm or  5.5 × 15 mm

Type II: 2.9 × 15.5 mm or 4.5 × 24 mm

About Atom:

ATOM Medical Devices Co., Ltd. is a leading manufacturer of standardized orthopedic implants and instruments for global distributors and importers.

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