Patellar fracture mapping: characteristics of fracture line distribution and risk factors for postoperative malposition

Fracture line mapping effectively elucidates the distribution characteristics of patellar fractures. The presence of an isolated medial fragment serves as an indicator of increased risk for postoperative lateral patellar displacement. Consequently, intraoperative management should prioritize the minimization of soft tissue stripping and the secure fixation of this fragment; when necessary, imbrication of the medial soft tissues should be performed to maintain patellar alignment. For comminuted fractures, particularly those involving lamination and comminution of the non-articular surface of the inferior pole, achieving sufficiently rigid fixation is essential. Such reinforced stability is likely required to minimize the risk of elongation, serving as the prerequisite for safe, early functional rehabilitation.