Targeted Stabilization of the Inferior Pole in Complex Patellar Fractures Using a low-profile Hooked Plate and cerclage

Abstract Objective To evaluate the early clinical outcomes of a low-profile hooked locking plate combined with cerclage for the treatment of complex patellar fractures, including comminuted and inferior pole fracture patterns. Methods This retrospective single-center study included 43 consecutive patients with complex patellar fractures treated between April 2024 and March 2025. All patients underwent open reduction and internal fixation using a patient-specific 3D-printed low-profile hooked locking plate. Outcomes assessed included fracture union, time to union, pain visual analogue score (VAS), range of motion, Böstman score, complications, and reoperations. Results Fracture union was achieved in 42 of 43 patients (97.7%), with a mean time to union of 8.48 ± 1.31 weeks. Functional outcomes were favorable, with a median Böstman score of 30 (IQR, 28–30), median range of motion of 135° (IQR, 130°–140°), and median VAS of 0 (IQR, 0–1). The overall complication rate was 11.6%, and the complication-related reoperation rate was 7.0%. No fixation failure of the inferior pole was observed. Conclusion The low-profile hooked locking plate combined with cerclage provided reliable fixation and favorable early outcomes in complex patellar fractures.