Because the requirements for immediate weight bearing and typically high-energy nature of the fracture, successful surgical repair is usually not possible.
If surgical repair is attempted, reestablishing the stay-apparatus using implants applying tension band technique to counteract the distracting forces of the quadriceps muscle and the patellar ligaments is required. A combination of implants including bone screws, wires, Steinmann pins and/or small bone plates may be used.
This procedure is performed with the patient placed in dorsal recumbency through the skin incision for patellar fractures.