Neglected patella nonunion successfully treated after 8 years by quadriceps distractive lengthening with a spanning unilateral external fixation system

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Vol. 26; no. 9; pp. 2784 - 2787
• Main Authors: Paxinos, Odysseas, Karamitros, Athanasios, Douras, Panagiotis, Kouris, Nikolaos
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-09-2018; Springer Nature B.V
• Subjects: Adult; Contraction; Female; Fixation; Fractures, Ununited - surgery; Humans; Knee; Knee Joint - surgery; Medicine; Medicine & Public Health; Nonunion; Orthopedic Equipment; Orthopedics; Patella; Patella - surgery; Quadriceps muscle; Quadriceps Muscle - surgery; Range of Motion, Articular; Reconstructive Surgical Procedures; Repair; Sutures
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-017-4738-9

Neglected patella non-unions are rare. Contraction of the quadriceps makes late repair extremely difficult. A case of distal patella pole fracture neglected for 8 years is presented. The patient was a hemiplegic young female unable to walk due to extensor mechanism deficiency with a 10 cm retraction of the patella proximal pole at her neurologically intact side. The quadriceps was lengthened using a spanning unilateral external fixation system and the fragments successfully united after trans-osseous suture repair. At 4-year follow-up the patient was independently ambulating without symptoms with a functional knee range of motion.
Level of evidence
IV.