Objectives: To assess the clinical and radiographic outcomes of a consecutive series of patellar fractures treated utilizing an anatomically contoured variable-angle patellar plating system (PPS) (Synthes; Paoli, PA).

Methods: Design: Retrospective chart review.

Setting: Single, academic, Level-1 Trauma center.

Patient selection criteria: All adult patients who underwent fixation of a patellar fracture (AO/OTA 34) with the PPS between 2021 and 2024 with a minimum follow-up of 3 months. Post-operatively, full extension was maintained for six weeks.

Outcome measures and comparisons: The primary outcome was fixation failure. Secondary outcomes included range of motion (ROM) at final follow-up, knee pain due to symptomatic implants, infection, and reoperation. Deep infection was defined as a return to the operating room for irrigation and debridement.

Results: There was a total of 61 patients with a mean age of 54 years (19-92 years). The cohort consisted of 32 females (52%) with a mean BMI of 27 kg/m2 (18-42 kg/m2). Fifteen patients (25%) had diabetes and 16 patients were smokers (26%). The average follow-up was 7 months (range 3 - 26 months).There were 2 34A1 fractures, 1 34B1 fracture, 16 34C1 fractures, 10 34C2 fractures, and 32 34C3 fractures. There were 6 open fractures (1%), 2 type II and 4 type IIIA.There were 54 (89%) patients who achieved uneventful healing. Seven patients (11%) experienced a postoperative complication. One patient developed a superficial wound infection which resolved with oral antibiotic therapy, 3 patients developed arthrofibrosis necessitating further intervention, 2 patients experienced fixation failure with one requiring revision fixation, and 1 patient developed osteomyelitis and underwent implant removal after fracture union. Of the 3 patients with arthrofibrosis one underwent manipulation under anesthesia, and two underwent arthroscopic lysis of adhesions.

Conclusions: The PPS may be utilized to stabilize challenging patellar fractures, leading to reliable union and minimal implant-related complications when associated with a post-operative protocol of full extension maintained for six weeks.

Level of evidence: Level IV.

Keywords: Complications; Knee; Novel Implant; Patellar Fracture.

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目标： 评估使用解剖轮廓可变角度髌骨板系统（PPS）（Synthes; 宾夕法尼亚州Paoli）治疗连续系列髌骨骨折的临床和放射学结果。

方法： 设计：回顾性病历审查。

环境设置： 单一学术机构的一级创伤中心。

患者选择标准： 所有在2021年至2024年间使用PPS固定髌骨骨折（AO/OTA 34）且至少有三个月随访的成年患者。术后，患者需维持全伸展状态六周。

结果测量及比较： 主要结局是内固定的失败。次要结局包括最终随访时的关节活动范围（ROM）、因症状性植入物引起的膝痛、感染和再次手术。深部感染被定义为返回手术室进行冲洗和清创。

结果： 共有61名患者，平均年龄54岁（19-92岁）。研究群体中有32名女性（52%），平均BMI为27 kg/m²（18-42 kg/m²）。有15名患者（25%）患有糖尿病，16名患者是吸烟者（26%）。平均随访时间为7个月（范围3-26个月）。其中，2例为34A1骨折、1例为34B1骨折、16例为34C1骨折、10例为34C2骨折和32例为34C3骨折。有6名患者（1%）发生开放性骨折，其中2名为II型、4名为IIIa型。89%的患者实现了无并发症愈合。7名患者（11%）经历了术后并发症。一名患者发生了浅表伤口感染并用口服抗生素治疗缓解；3名患者出现关节粘连需要进一步处理；两名患者经历内固定失败，其中一人需要进行修复性固定；还有一名患者发生骨髓炎并在骨折愈合后移除植入物。在三例因关节粘连而出现问题的病例中，一名接受了麻醉下的复位治疗，另外两名为松解粘连进行了关节镜手术。

结论： PPS可用于稳定具有挑战性的髌骨骨折，并且结合术后六周维持全伸展状态的方案，可以实现可靠的愈合并减少与植入物相关的并发症。

证据水平： IV级。

关键词： 并发症；膝关节；新型植入物；髌骨骨折。