# Plateau and Patella: A Framework for Ipsilateral Injury Fixation

## TL;DR

This paper presents a new surgical management approach for a rare injury involving both the patella and tibial plateau.

## Contribution

The paper introduces a novel surgical framework for managing ipsilateral patella and tibial plateau fractures, which have not been previously documented.

## Key findings

- A 57-year-old patient was successfully treated with ipsilateral patella and tibial plateau fixation through a midline incision.
- Postoperative recovery using a hinged knee brace showed no complications at three months.
- The proposed management plan offers a potential guide for treating this rare injury pattern.

## Abstract

Ipsilateral patella and tibial plateau fractures represent an extremely rare injury pattern. They are seldom discussed in literature, with no frameworks for management being reported that we were able to find. We report our experience and management of such an injury, suffered by a 57-year-old female patient with good premorbid functional status, by direct trauma to the right knee. Preoperatively, she was managed in a knee splint to aid elevation and help control her pain. We undertook fixation of both the patella and tibia through a midline incision. Postoperatively, we used a hinged knee brace, initially locked in extension, to allow gradual flexion at two weekly follow-ups. She has suffered no postoperative complications thus far at three months.

We hope to highlight a novel management plan for this rare and complex fracture pattern, for which no prior published management evidence exists. As such, we submit the key principles from which our operative plan was derived to aid in the management of such injuries in the future.