Purpose <p>The purpose of this retrospective study was to investigate the efficacy and functional outcomes of utilizing a flexible separate vertical suture fixation technique in osteoporotic patients presenting with comminuted fractures of the inferior patellar pole.</p> Methods <p>A flexible separate vertical suture fixation by braided polyester was applied. Between January 2021 and December 2022, 19 patients diagnosed as comminuted inferior patella fracture with osteoporosis were retrospectively enrolled in this study.</p> Results <p>The mean operative time was 34.2 ± 3.2&#xa0;minutes, bone union achieved in all cases at an average of 3.1 ± 0.5 months after surgery. At the last follow up, the mean ROM was 132.1 ± 2.9°, and the mean Bostman score was 29.1 ± 0.9. During follow up, no instances of wire cutting or internal fixation failure occurred among the patients, no instances of postoperative anterior knee pain or refracture of the inferior patellar pole were observed and no surgical removal of implants was performed for any of the patients.</p> Conclusions <p>The flexible separate vertical suture fixation by thread is an effective fixation method for comminuted inferior patella fracture, especially for those elderly patients with osteoporosis.</p>