# Stress Avulsion Fracture of the Patellar Tendon Following Open Reduction and Internal Fixation of a Transverse Patella Fracture With Cannulated Screws

## TL;DR

A 65-year-old woman developed a rare stress-avulsion fracture after patella surgery, which was successfully treated by adjusting the implant placement.

## Contribution

Highlights a rare complication of patellar fracture fixation and provides a solution to prevent implant-related stress fractures.

## Key findings

- A stress-avulsion fracture occurred due to a prominent screw head after patella fixation.
- The fracture was successfully treated by burying the screw head and using cerclage wire.
- Surgical techniques must address implant-related stress risers to prevent such complications.

## Abstract

A stress-avulsion fracture of the inferior pole of the patella is rare. We report a case of a 65-year-old woman who underwent open reduction and internal fixation for a transverse fracture of the patella using cannulated screws inserted from the inferior pole of the patella. Subsequently, the patient developed an avulsion fracture of the inferior pole of the patella due to a stress riser from the prominent screw head. The avulsion fracture was treated with open repair and augmentation using a cerclage wire, and the stress riser was eliminated by burying the screw head into the bone. The outcomes were satisfactory. Preventing implant-related stress risers during internal fixation of fractures requires diligent surgical techniques.