Patella bone plate and methods of fixation
A patella fracture fixation system includes a peripheral rim bone plate that is configured to be implanted along a parapatellar lateral approach. The bone plate can configured to minimize disruption of blood supply to the patella. The bone plate can be augmented with a Krackow suture pattern to assist in stabilization of a comminuted inferior pole.
1. A method of treating a fractured patella, the method comprising the steps of:
creating a longitudinal skin incision along a lateral border of the patella;
inserting a bone plate through the incision and around at least a portion of the patella, such that 1) a row of bone fixation holes of a base of the bone plate faces a lateral portion of a circumferential rim of the patella, an inferior pole of the patella, and a superior pole of the patella, and 2) an outer portion of the bone plate that extends from the base faces an anterior surface of the patella;
driving a first fixation element through one of the bone fixation holes of the base and into the circumferential rim;
driving second fixation elements through the bone plate and into respective ones of the inferior pole and the superior pole; and
driving an anterior fixation element through the outer portion and into the anterior surface of the patella.
2. The method of claim 1 , wherein the step of driving a first fixation element comprises driving a plurality of first fixation elements through respective ones of the bone fixation holes of the base and into the circumferential rim.
3. The method as recited in claim 1 , further comprising, after the creating step and before the inserting step, the step of performing a lateral parapatellar arthrotomy.
4. The method as recited in claim 3 , further comprising the step of angulating the patella so as to gain direct visual access of an articular surface of the patella.
5. The method as recited in claim 4 , wherein the step of angulating is performed prior to the step of driving the lateral fixation element.
6. The method as recited in claim 4 , wherein the step of driving second fixation elements comprises the step of driving a superior fixation element of the second fixation elements through the bone plate and into the superior pole of the patella, so as to fix the bone plate to the superior pole.
7. The method as recited in claim 6 , wherein the step of driving the superior fixation element compresses the bone plate against the superior pole of the patella, and further causes the at least one superior fixation element to threadedly purchase with cortical bone at the inferior pole.
8. The method as recited in claim 6 , wherein the step of driving second fixation elements further comprises the step of driving an inferior fixation element of the second fixation elements through the bone plate and into the inferior pole of the patella so as to fix the bone plate to the inferior pole.
9. The method as recited in claim 8 , wherein the step of driving the inferior fixation element further comprises threadedly purchasing the inferior fixation element in cortical bone of the superior pole.
10. The method as recited in claim 8 , wherein the step of driving the inferior fixation element comprises the step of threadedly mating a head of the inferior fixation element to the base of the bone plate.
11. The method as recited in claim 8 , further comprising the step of directly visually inspecting the articular surface during at least one of the driving steps.
12. The method as recited in claim 8 , further comprising the step of passing a suture between the second portion of the plate and the patella, stitching the suture into a patellar tendon that is attached to the patella, and attaching the at least one suture to the bone plate.
13. The method as recited in claim 1 , wherein the driving steps comprise driving the first fixation element through a first eyelet that defines the one of the bone fixation holes of the base, and driving the second fixation elements through respective eyelets of the base that define respective bone fixation holes of the bone plate.
14. The method as recited in claim 13 , wherein the driving steps comprise threadedly purchasing the first and second fixation elements with the base, and threadedly purchasing the anterior fixation element with the outer portion.
15. The method as recited in claim 1 , wherein the bone plate comprises:
a bone plate body defining an inner surface configured to face the patella, and an outer surface opposite the inner surface, the bone plate body including:
i) the row having an intermediate section that is configured to be fixed to the lateral portion of the circumferential rim of the patella, a first outer section that extends substantially along a first select longitudinal direction from the intermediate section and is configured to be fixed to the superior pole of the patella, and a second outer section that extends from the intermediate section substantially along a second select longitudinal direction opposite the first select longitudinal direction and is configured to be fixed to the inferior pole of the patella; and
ii) the outer portion that extends from the base along a first select lateral direction, the outer portion defining a plurality of bone fixation holes,
wherein each of the intermediate section, the first outer section, the second outer section, and the outer portion defines a respective at least one bone fixation hole, the first outer section defines a first bone fixation hole that is disposed outward with respect to all bone fixation holes of the outer portion along the first select longitudinal direction, and the second outer section defines a second bone fixation hole that is disposed outward with respect to all bone fixation holes of the outer portion along the second select longitudinal direction, wherein all bone fixation holes of the row are inline with each other along a longitudinal direction that includes each of the first select longitudinal direction and the second select longitudinal direction, and
the bone plate is devoid of bone fixation holes that are spaced from the row in a second select lateral direction that is opposite the first select lateral direction.