A case report on non-union of the inferior pole of the patella: A surgical dilemma

Abstract

Introduction: Patellar non-union are rare orthopaedic cases. Treatment of these cases is a problem as no set protocol has been laid down to manage them. Case report: We present a case of a 40-year-old man with a year-old inferior pole of patella non-union. Radiographs and clinical findings in the right knee helped us make the diagnosis. Once diagnosis was made the patient was managed with open reduction and internal fixation with a double tension band wiring. The fixation was supplemented with cortico cancellous graft obtained from the right iliac crest. Additional encirclage wiring was done and passed through the patellar tendon and tibial tuberosity to prevent flexion beyond the desired limit. Bony union was seen at 5 months and the circlage wire was removed at that point of time. Post operatively the patient underwent rigorous rehabilitation exercises to achieve a final range of motion from 0 to 110 degrees at the end of 7 months.Conclusion: Double tension band wiring with quadriceps V-Y plasty and bone grafting is a good treatment modality for patellar non-unions.