Abstract
We report our surgical method used to treat type C distal femur fractures accompanied
by patella fractures whereby we approach the articular surface of the femur through
the already-fractured patella. We treated 10 patients with type C3 distal femur and
patella fractures between May 2013 and April 2015. Because the patella was fractured
in all cases, we could approach the articular surface of the distal femur through
the transverse gap between the retracted patellar fracture fragments, “transpatellar
approach.” Any surgical complications were recorded. Knee function was evaluated using
the Böstman system. The average age of the 10 patients (8 males) was 42.9 years (range,
22.0–58.0 years). All distal femur fractures were type C3, combined with patella fractures.
Bony union of the distal femur and patella was achieved in all but one patient, who
required an additional bone graft (without any change in the implant). Overall, three
patients (30%) reported excellent results and seven (70%) reported good results, based
on the Böstman system. A midline anterior approach through a patella fracture adequately
exposes the entire joint surface of the distal femur, except the posterior surface.
This approach is useful when treating a type C distal femur fracture accompanied by
a patella fracture. The level of evidence is IV.
Keywords
transpatellar approach - distal femur fracture - patellar fracture
