TREATMENT OF INFERIOR POLE FRACTURE OF THE PATELLA IN ADULTS: SYNTHESIS OF CLINICAL EVIDENCE.

Abstract

Fractures of the Inferior pole patellar fracture (IPPF) affect the distal end of the bone, where the patellar tendon inserts, and are more common in young, active adults due to direct trauma or intense muscle contractions. This region, which is structurally more fragile and subjected to high tensile loads, becomes vulnerable to fractures that compromise the knee extensor mechanism, resulting in pain, functional limitation, and loss of mobility. Treatment can be conservative or surgical, depending on the degree of displacement and the integrity of the extensor apparatus, and involves various techniques, including minimally invasive procedures. Given the clinical relevance and controversy regarding optimal management, it is necessary to synthesize the available evidence to support therapeutic decisions and optimize functional outcomes. To review the literature on the treatment of IPPF in adults. The search was performed in the PUBMED database using the following search strategy: inferior[title] AND pole[title] AND patella[title] AND fracture[title], with a time cut-off of five years.

Results: Initially, 22 studies were identified that met the previously established search strategy. After reading the titles and abstracts, six studies were excluded, leaving 16 articles that constituted the sample for this review. The studies demonstrated stable fixation techniques for IPPF that favored bone consolidation and early functional recovery, but the choice of the ideal method still depends on the type of IPPF, the surgeon's experience, and the reduction of complications such as reoperations, in addition to the presence of a low patella. Level of Evidence IV, Case Series.