Bipartite patella separation with quadriceps tendon avulsion: A rare surgical case

This is the authors' abstract. We don't add key points for this paper.

The occurrence of bipartite patellar disruption simultaneously with quadriceps tendon avulsion is an extremely rare injury. A literature review found three documented cases in which only two repaired both the patella and tendon. We present a case report outlining this unusual injury and propose a method of surgical treatment. A 45-year-old male presented following a fall directly onto his knee, with no significant medical history or previous injury. He was diagnosed with both separation of a type III bipartite patella and a clinical suspicion of a quadriceps tendon rupture. Intra-operatively, we found a complete tear of the quadriceps tendon at its insertion to the patella with disruption of the synchondrosis and significant separation of the bipartite patella. The displaced fragment was reduced and held using two cannulated screws, the quadriceps tendon was reattached to the superior pole of the patella using two anchor sutures and the retinaculum repaired. We could find no documented cases of using both cannulated screws and anchor sutures as a fixation method for this injury. We recommend this technique as we found that it gave a stronger fixation and was associated with a good functional outcome for our patient.