Dorsal Hook Plating of Patella Fractures With Immediate Range of Motion Results in Reliable Fixation, Low Implant Removal Rates, and Satisfactory Clinical Outcomes.

Abstract

Objectives: To evaluate radiographic and clinical patient-reported outcomes following dorsal hook plating of displaced patella fractures with permittance of immediate postoperative active closed chain range of motion.

Methods:

Design: Retrospective review of prospectively collected data.

Setting: Urban academic level 1 trauma center.

Patient selection criteria: Adult patients with displaced patella fractures (OTA/AO 34C1-3) who underwent dorsal plating with immediate range of motion between 2018 and 2023.

Outcome measures and comparisons: Numerical Rating Scale for Pain, Knee Outcome Score (KOS-ADL), Tegner-Lysholm score, radiographic union, and wound complications were collected.

Results: Sixty-one patients were included (47 female) with an average age of 63 years (SD 14.7, range 22-86 years). The mean BMI was 24.2 (SD 3.6, range 16.6-33.3). There were 13 34-C2 and 48 34-C3 fractures. All but 2 patients (96.7%) achieved bony union after the index procedure. 89% (n = 54) of patients completed outcome surveys with at least 6-month follow-up. Six patients (9.8%) underwent removal of plate implant at a mean of 15.1 months postoperatively. The mean KOS-ADL score was 91.4, the mean Tegner-Lysholm score was 78.1, and the mean NRS was 2.7.

Conclusions: Dorsal hook plating offers secure fixation to allow early range of motion, reliable fixation with low nonunion and implant failure rates, low implant removal rates, and satisfactory patient-reported outcomes.

Level of evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.