A new research article, “High Failure Rates in Comminuted Patella Fractures (AO/OTA 34-C3) Fixed With an Isolated, New Patella-Specific 2.7-mm Variable-Angle Locking Plate” was published in the Journal of Orthopedic Trauma in June 2025.
The study compared outcomes of comminuted patella fractures treated with a patella‑specific 2.7‑mm variable‑angle locking plate alone versus the same plate supplemented with soft‑tissue or bony augmentation. 
Among 38 patients, fixation failure was significantly more common when the plate was used in isolation, 40% in the plate‑only group versus 11.1% when augmentation was added. Even after controlling for bone‑quality risk factors using FRAX scores, augmentation remained strongly protective, with an odds ratio of 0.14, indicating substantially lower risk of fixation loss.
The authors conclude that plate‑only fixation carries a high failure rate in comminuted patella fractures, while adding targeted augmentation, especially addressing the tendon avulsion component of the extensor mechanism, meaningfully improves stability. Restoring soft‑tissue continuity appears critical to preventing distal fixation loss, the most common failure mode.
These findings support a shift toward combined plate‑and‑augmentation constructs for complex patella fractures and highlight the importance of extensor mechanism repair in achieving durable fixation.
