A New Method of Krackow Suture Combined with Nice Knot for the Treatment of Inferior Patellar Fractures

We present a new surgical technique of Krackow suture combined with vertical Nice knot for the treatment of inferior patellar fractures and report the clinical results.

Seventeen consecutive patients admitted with inferior patellar fractures over a 2-year period from June 2019 to February 2022 were prospectively enrolled. The AO classification was 34-A1. All patients underwent open reduction and fixation with Krackow sutures in combination with vertical Nice knot. Postoperative follow-up was performed for at least 1 year to evaluate knee function.

The mean age of seventeen patients was 53.2 ± 9.5 years (39–68 years), and all patients were followed up for more than 12 months. The operation time was 54.6 ± 7.7 min (42–68 min). No patients had nonunion, joint stiffness, and joint pain. All cases achieved bony union at an average of 9.9 ± 1.5 weeks (8–13 weeks) after surgery. At the last follow-up, there was no significant difference in range of motion between the injured knee (129.7 ± 3.3°, range 125–135°) and the unaffected knee (130.8 ± 3.8°, range 126–137°) (t = 0.28, P > 0.05). The mean Bostman score of the knee joint was 29.6 ± 0.7, including 15 excellent cases (88.2%) and two good case (11.8%).

Krackow sutures combined with vertical Nice knots are stable and reliable in the treatment of inferior patellar fractures. Knee rehabilitation can be performed immediately after surgery and satisfactory knee function can be achieved. It is a safe, simple, and reliable alternative surgical method, and patients do not need to bear the secondary surgical injury of removing the internal fixation material. Therefore, it is suitable for the application of clinical promotion.