title: Internal fixation of patellar apex fractures with the basket plate: 25 years of experience.
abstract: BACKGROUND
  Comminution of the patellar apex is amenable to internal fixation by standard techniques and usually requires partial patellectomy. In our institution, multifragmentary fractures of the distal pole are treated with the basket plate, which is shaped to fit the geometry of the patellar apex. This implant has been used in our institution for over 25 years. The aim of this study was to evaluate long-term results of internal fixation of comminuted fractures of the patellar apex with the basket plate.
  
  
  METHODS
  A total of 142 patients with fracture of the distal pole of the patella were treated with the basket plate between 1988 and 2013. Functional evaluation was conducted using the modified Cincinnati knee rating system. A total of 98 patients were available for late functional evaluation.
  
  
  RESULTS
  There were no infections or implant-related problems during the follow-up period. All fractures healed within 8 to 10 weeks. There were three cases of early revision because of improper use of the implant and incorrect indication. Functional outcome following internal fixation with the basket plate was excellent in 80 patients and good in 18; there were no poor results.
  
  
  CONCLUSIONS
  Internal fixation with the basket plate is recommended for management of multifragmentary fractures of the patellar apex because this method enables early, unrestricted knee motion, and provides reliable healing and good functional outcome. This method is an alternative to partial patellectomy and is considered a patella-saving procedure; therefore, the use of the basket plate is strongly recommended for the treatment of distal pole fractures.
authors.affiliation: University Hospital "Sisters of Mercy", Department of Trauma and Orthopaedic Reconstructive Surgery, Vinogradska cesta 29, 10000 Zagreb, Croatia.
authors.forename: Aljoša
authors.initials: A
authors.lastname: Matejčić
authors.affiliation: University Hospital "Sisters of Mercy", Department of Trauma and Orthopaedic Reconstructive Surgery, Vinogradska cesta 29, 10000 Zagreb, Croatia.
authors.forename: Mihovil
authors.initials: M
authors.lastname: Ivica
authors.affiliation: General Hospital "Josip Benčević", Andrije Štampara 42, 35000 Slavonski Brod, Croatia.
authors.forename: Darko
authors.initials: D
authors.lastname: Jurišić
authors.affiliation: University Hospital "Sisters of Mercy", Clinic for Traumatology, Draškovićeva 19, 10000 Zagreb, Croatia.
authors.forename: Tomislav
authors.initials: T
authors.lastname: Ćuti
authors.affiliation: Department of Surgery, General Hospital Karlovac, Dr. Andrije Štampara 3, 47000 Karlovac, Croatia.
authors.forename: Bore
authors.initials: B
authors.lastname: Bakota
authors.affiliation: University Hospital "Sisters of Mercy", Department of Trauma and Orthopaedic Reconstructive Surgery, Vinogradska cesta 29, 10000 Zagreb, Croatia. Electronic address: dinko.vidovic@gmail.com.
authors.forename: Dinko
authors.initials: D
authors.lastname: Vidović
mesh_terms: D001860:Bone Plates; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D050723:Fractures, Bone / Q000503:physiopathology / Q000601:surgery*; D018460:Fractures, Comminuted / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D010329:Patella / Q000293:injuries / Q000503:physiopathology / Q000601:surgery*; D020127:Recovery of Function; D016896:Treatment Outcome; D016474:Weight-Bearing
keywords: Basket plate; Internal fixation; Patella fractures; Patellectomy