Management of the displaced transverse fracture patella by a new technique of transosseous fixation with endobuttons

Background: Although tension-band wiring is the most widely used technique to treat patellar fractures, metal implant-related complications such as implant failure, palpable hardware are very common and additional procedures are often necessary to treat the complications. We are presenting a new technique of fixing transverse patellar fractures with endobuttons which has minimal hardware-related complications. Materials and Methods: A total of 25 patients with <3 weeks old closed displaced transverse fractures patella of age <60 years were treated by this technique. At the end of 1-year follow-up, Rasmussen's knee score, extension lag, range of flexion, and thigh circumference were measured. Results: At the end of mean follow-up of 13.44 ± 1.29 months, all the fractures attained union. In 80% of cases, there was no quadriceps wasting, 72% of cases had no extension lag and range of flexion was more than 120° in 64% of cases. The Rasmussen's knee score was excellent in 72%, good in 20%, and fair in 8% of cases. Mean knee score found to be 25.8 ± 4.5 (good). The values of extension lag and range of flexion at the end of 2 weeks and 1-year postoperatively were compared, and change in the values found to be statistically significant at P < 0.05. Conclusions: The transosseous suturing with endobuttons is a safe and effective fixation technique for the treatment of displaced transverse fracture patella. It allows for rapid recovery with minimal implant-related complications. Its use should be considered in the treatment of transverse fractures patella.