Abstract
Introduction Comminuted fractures of the distal pole of the patella represent a challenge for
the knee surgeon, as there is no standard treatment that enables accelerated rehabilitation.
Osteosynthesis and reattachment of the distal pole using vertical wire loops has recently
been described.
Materials and Methods We herein present two cases of comminuted fracture of the distal pole of the patella
resolved with vertical wire loops and modifications of this technique.
Results Osteosynthesis of the distal pole of the patella was performed, achieving a satisfactory
radiographic reduction and enabling accelerated rehabilitation, with a progressive
range of motion the day after the surgery. The patients achieved full range of motion
two and three months after surgery. They progressed satisfactorily, without complications
related to this technique and its variations, and were discharged four months after
the reduction and osteosynthesis.
Discussion The traditional techniques for the management of distal pole fractures involve special
considerations regarding rehabilitation and associated complications. The vertical
wire loop technique was used in two patients: in one of them, it was supplemented
with a Krackow suture; and, in the other, with a mini-fragment plate, which enabled
accelerated rehabilitation and early return to work.
Conclusion The use of vertical wire loops appears to be a safe technique, which enables accelerated
rehabilitation and early return to work.
Level of evidence: V.
