Multi-Fragment Patellar Non-Union in a Young Patient Due to Failed Fixation and its Management – A Rare Case Report

Abstract

Introduction: Multi-fragmentary patellar non-union is rare and it causes functional disability in patients. The purpose of studying this case is to present an unusual patella multi-fragmentary non-union and discuss its management. Case presentation: We present a case of a 25-year-old male patient presented with pain and instability and decreased movements of the right knee since last 1 year. The patient had a history of trauma for which he was operated at the local hospital. X-ray and CT scan of the right knee was suggestive of the non-union of the right patella with three main fragments. We managed with open reduction and internal fixation using CC screw, cerclage and tension band wiring. At one-year follow up, the patient is having a clinical and radiological union of non-union with good functional outcome. Conclusion: Combination of cannulated cancellous screw, cerclage and tension band wiring provides stable fixation in the multi-fragmentary patellar non-union, helps in early mobilisation which in turn helps in getting good functional outcome and prevents implant-related complications. Keywords: Non-union; Multi-fragmentary patella; Internal fixation; Fixation failure.