Tag Archive for: Internal fixation

Multi-Fragment Patellar Non-Union in a Young Patient Due to Failed Fixation and its Management – A Rare Case Report

Vol 7 | Issue 1 | January-June 2021 | page: 12-14 | Neetin P Mahajan, Prasanna Kumar GS, Pranay Kondewar, Kishor Jadhav

Author: Neetin P Mahajan [1], Prasanna Kumar GS [1], Pranay Kondewar [1], Kishor Jadhav [1]

[1] Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India.
Address of Correspondence
Dr. Prasanna Kumar GS,
Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India.
E-mail: prasannakumargs5@gmail.com


Introduction: Multi-fragmentary patellar non-union is rare and it causes functional disability in patients. The purpose of studying this case is to present an unusual patella multi-fragmentary non-union and discuss its management.
Case presentation: We present a case of a 25-year-old male patient presented with pain and instability and decreased movements of the right knee since last 1 year. The patient had a history of trauma for which he was operated at the local hospital. X-ray and CT scan of the right knee was suggestive of the non-union of the right patella with three main fragments. We managed with open reduction and internal fixation using CC screw, cerclage and tension band wiring. At one-year follow up, the patient is having a clinical and radiological union of non-union with good functional outcome.
Conclusion: Combination of cannulated cancellous screw, cerclage and tension band wiring provides stable fixation in the multi-fragmentary patellar non-union, helps in early mobilisation which in turn helps in getting good functional outcome and prevents implant-related complications.
Keywords: Non-union; Multi-fragmentary patella; Internal fixation; Fixation failure. 




1. E. J. Eric, “Fractures do joelho,” in Fractures em adultos, R. CAJ, D. P. Green, and R. W. Bucholz, Eds., vol. 1991, pp. 1729–1744, Lippincott, Philadelphia, PA, USA, 3rd edition.
2. Klassen JF, Trousdale RT. Treatment of delayed and nonunion of the patella. J Orthop Trauma. 1997;11(3):188–194.
3. Lachiewicz PF. Treatment of a neglected displaced transverse patella fracture. J Knee Surg. 2008;21:58–61.
4. Satku K, Kumar VP. Surgical management of non-union of neglected fractures of the pa-tella. Injury. 1991;22:108–10.
5. Dhar SA, Mir MR. Use of the Illizarov method to reduce quadriceps lag in the manage-ment of neglected non union of a patellar fracture. J Orthop. 2007;4:12.
6. Nathan ST, Fisher BE, Roberts CS, Giannoudis PV. The management of nonunion and delayed of unionof patella fractures: A systematic review of the literature. Int Orthop. 2011;35:791–5.
7. R. K. Baruah, “Modified Ilizarov in difficult fracture of the patella. A case report,” Jour-nal of Orthopaedic Case Reports, vol. 6, no. 1, pp. 26–28, 2016.
8. C. Gwinner, S. Märdian, P. Schwabe, K. D. Schaser, B. D. Krapohl, and T. M. Jung, “Cur-rent concepts review: fractures of the patella,” GMS Interdisciplinary plastic and recon-structive surgery DGPW, vol. 5, pp. 1–15, 2016.
9. Sutton S, Jr, Thompson C, Lipke J, Kettelkamp D. The effect of patellectomy on knee function. J Bone Joint Surg Am. 1976;58:537–40.
10. Lennox IA, Cobb AG, Knowles J, Bentley G. Knee function after patellectomy a 12- to 48-year follow-up. J Bone Joint Surg Br. 1994;76:485–7.

How to Cite this article: Mahajan NP, Prasanna Kumar GS, Kondewar P, Jadhav K | Multi-Fragment Patellar Non-Union in a Young Patient Due to Failed Fixation and its Management- A Rare Case Report | Trauma International | January-June 2021; 7(1): 12-14.


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