Favorable Results Following Patella Fracture Fixation With 2.7 mm Variable Angle Locking Plates: A Technical Note and Case Series

Introduction: The primary objective of this study was to describe a technique using a 2.7 mm variable-angle (VA) locking plate fixation in combination with ex situ and in situ plate contouring, a high screw density, a “homerun” screw, and routine postoperative immobilization to obtain reliable outcomes following patella fractures. The secondary objectives were to determine the rate of postoperative complications and the range of motion at final follow-up, as well as the time to weight-bearing as tolerated and the time to range-of-motion as tolerated. Methods: All consecutive adult patients treated with a 2.7 mm VA locking plate for a patella fracture (AO/OTA 34) between January 2021 and January 2025 were retrospectively identified from one Level 1 trauma center. The use of 2.7 mm VA locking plates and augmented fixation was determined through operative reports and radiographs. Results: Thirty-seven patients treated with the technique were identified. One patient (2.7%, 95% CI: 0.07%-14%) experienced construct failure, and 4 patients (11%, 95% CI: 3.0%-25%) returned to the operating room (2 manipulations under anesthesia, 1 intra-articular screw removal, and 1 symptomatic hardware removal). No patients experienced infection or nonunion. At final orthopedic follow-up, the median RUST score was 12/12 (IQR=11 to 12). Conclusions: The described technique resulted in low rates of loss of fixation, implant failure, and removal of symptomatic implants, as well as reliable healing, following patella fracture fixation with a 2.7 mm VA locking plate.