Abstract
We report the results of surgical treatment for patellar lower pole fracture with patella baja employing the modified Mclaughlin procedure using a cable wire.
Because patellar lower pole fracture is associated with a small distalis bone chip, fixation using a wire circlage may be insufficient. Also, as patella baja results in quadriceps femoris muscle atrophy, surgery may become difficult because of flexural limitation.
We report a 78-year-old man who suffered a fall and a patellar lower pole fracture manifested by hyperflexion of the right knee. There was right tibial tubercle avulsion next after excision of a right femoral region liposarcoma, and patella baja was evident. The K-wire implant from the distalis side was difficult for a flexural limit, and the distalis bone chip was small, and fixation by the wire circlage was insufficient.Therefore we performed osteosynthesis through the patella and tibial tubercle, and synostosis and a good result was obtained by the Mclaughlin procedure using a cable wire.
However, when we employ the modified Mclaughlin procedure for patellar lower pole fracture, we need to insert a screw to the tibial tubercle and remove the implants early if there is the risk of cut-out after operation for bone fragility of the tibia and the patella.
