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Neglected patella nonunion successfully treated after 8 years by quadriceps distractive lengthening with a spanning unilateral external fixation system

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Neglected patella non-unions are rare. Contraction of the quadriceps makes late repair extremely difficult. A case of distal patella pole fracture neglected for 8 years is presented. The patient was a hemiplegic young female unable to walk due to extensor mechanism deficiency with a 10 cm retraction of the patella proximal pole at her neurologically intact side. The quadriceps was lengthened using a spanning unilateral external fixation system and the fragments successfully united after trans-osseous suture repair. At 4-year follow-up the patient was independently ambulating without symptoms with a functional knee range of motion.

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Correspondence to Nikolaos Kouris.

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The authors declare that they have no conflict of interest.


The authors received no financial support for the research, authorship, and/or publication of this article.

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Patient written consent and ethical approval by 251 Hellenic Air Force Hospital were granded for this paper.

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Paxinos, O., Karamitros, A., Douras, P. et al. Neglected patella nonunion successfully treated after 8 years by quadriceps distractive lengthening with a spanning unilateral external fixation system. Knee Surg Sports Traumatol Arthrosc 26, 2784–2787 (2018). https://doi.org/10.1007/s00167-017-4738-9

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