Functional Outcomes of Patellar Tendon Repair Following Tibial Tubercle Fragmentation Due to Gunshot Injury: A Case Report

Gunshot-related injuries involving the patellar tendon insertion are rare and represent a substantial challenge for extensor mechanism reconstruction. We present the case of a 35-year-old male patient who sustained a combined patellar tendon rupture and comminuted tibial tubercle fracture following a gunshot injury. Surgical reconstruction was performed using autologous hamstring graft augmentation, U-staples, and multiple suture anchors, followed by a structured rehabilitation protocol. Functional outcomes were assessed using the Lysholm score, KOOS, IKDC score, and isokinetic strength testing. At 3 months postoperatively, the Lysholm score was 21/100, IKDC was 27.3%, and KOOS demonstrated severe functional limitations. Isometric quadriceps strength corresponded to 14.1–14.4% of the uninjured limb. At 1-year follow-up, the Lysholm score improved to 76/100, KOOS-ADL reached 95%, and IKDC increased to 49.5%. Isokinetic evaluation demonstrated partial recovery in peak torque and total work compared with the contralateral extremity. This case demonstrates that, in rare gunshot-induced injuries involving combined patellar tendon rupture and tibial tubercle fragmentation, multi-point fixation supported by autologous graft augmentation and structured rehabilitation may provide acceptable short-term functional recovery. Nevertheless, persistent deficits in muscle strength and endurance emphasize the importance of prolonged rehabilitation and long-term follow-up.