Patellar fracture nonunion treated without reosteosynthesis: Case report

Patellar fractures are common injuries often managed with open reduction and internal fixation (ORIF); however, nonunion is a rare complication, with an incidence of 2.4%-12.5%. This case report describes a 26-year-old male who sustained a comminuted patellar fracture in a road traffic accident and...

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Main Authors: Abdulelah K. Alqawlaq, Abeer O. Ismail, Mohammad Maddah
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:Radiology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S1930043325001402
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author Abdulelah K. Alqawlaq
Abeer O. Ismail
Mohammad Maddah
author_facet Abdulelah K. Alqawlaq
Abeer O. Ismail
Mohammad Maddah
author_sort Abdulelah K. Alqawlaq
collection DOAJ
description Patellar fractures are common injuries often managed with open reduction and internal fixation (ORIF); however, nonunion is a rare complication, with an incidence of 2.4%-12.5%. This case report describes a 26-year-old male who sustained a comminuted patellar fracture in a road traffic accident and subsequently developed nonunion despite having a good range of motion and normal extension strength. He presented with persistent knee pain, and imaging confirmed the nonunion. Surgical removal of tension band wiring and cerclage was performed, revealing strong fibrous connections between the fracture fragments, and reosteosynthesis was deemed unnecessary. Postoperatively, the patient experienced complete pain relief and full functional recovery. This case highlights the importance of individualized treatment plans, demonstrating that not all cases of patellar nonunion require reosteosynthesis if the extensor mechanism remains intact, and that hardware removal alone can be an effective treatment strategy.
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spelling doaj-art-d41d0bc0162b4c82b7f89161075d69cf2025-08-20T01:57:40ZengElsevierRadiology Case Reports1930-04332025-05-012052360236410.1016/j.radcr.2025.02.038Patellar fracture nonunion treated without reosteosynthesis: Case reportAbdulelah K. Alqawlaq0Abeer O. Ismail1Mohammad Maddah2College of Medicine and Surgery, Batterjee Medical College, Jeddah, Saudi Arabia; Corresponding author.College of Medicine and Surgery, Batterjee Medical College, Jeddah, Saudi ArabiaDepartment of Trauma and Orthopedic Surgery, International Medical Center, Jeddah, Saudi Arabia; Department of Surgery, Orthopedic Section, University of Tabuk, Tabuk, Saudi ArabiaPatellar fractures are common injuries often managed with open reduction and internal fixation (ORIF); however, nonunion is a rare complication, with an incidence of 2.4%-12.5%. This case report describes a 26-year-old male who sustained a comminuted patellar fracture in a road traffic accident and subsequently developed nonunion despite having a good range of motion and normal extension strength. He presented with persistent knee pain, and imaging confirmed the nonunion. Surgical removal of tension band wiring and cerclage was performed, revealing strong fibrous connections between the fracture fragments, and reosteosynthesis was deemed unnecessary. Postoperatively, the patient experienced complete pain relief and full functional recovery. This case highlights the importance of individualized treatment plans, demonstrating that not all cases of patellar nonunion require reosteosynthesis if the extensor mechanism remains intact, and that hardware removal alone can be an effective treatment strategy.http://www.sciencedirect.com/science/article/pii/S1930043325001402Patellar fracture nonunionTension band wiringReosteosynthesisExtensor mechanismFibrous tissue connectionComminuted fracture
spellingShingle Abdulelah K. Alqawlaq
Abeer O. Ismail
Mohammad Maddah
Patellar fracture nonunion treated without reosteosynthesis: Case report
Radiology Case Reports
Patellar fracture nonunion
Tension band wiring
Reosteosynthesis
Extensor mechanism
Fibrous tissue connection
Comminuted fracture
title Patellar fracture nonunion treated without reosteosynthesis: Case report
title_full Patellar fracture nonunion treated without reosteosynthesis: Case report
title_fullStr Patellar fracture nonunion treated without reosteosynthesis: Case report
title_full_unstemmed Patellar fracture nonunion treated without reosteosynthesis: Case report
title_short Patellar fracture nonunion treated without reosteosynthesis: Case report
title_sort patellar fracture nonunion treated without reosteosynthesis case report
topic Patellar fracture nonunion
Tension band wiring
Reosteosynthesis
Extensor mechanism
Fibrous tissue connection
Comminuted fracture
url http://www.sciencedirect.com/science/article/pii/S1930043325001402
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