Name: Patellar Fracture Fixation Featuring the Arthrex Trauma Mini Fragment System
Uploaded: 2026-07-17T12:58:00Z
Channel: Arthrex
Description: Mitchel Obey, MD (St. Louis, MO), discusses key design features of the Arthrex Mini Fragment System and how they may be used in patellar fracture management.

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Trauma Lower Extremities

Mitchel Obey, MD (St. Louis, MO), discusses key design features of the Arthrex Mini Fragment System and how they may be used in patellar fracture management.

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VID1-008975-en-US | A | Patellar Fracture Fixation Featuring the Arthrex Trauma Mini Fragment System

Mitchel Obey, MD

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Patellar Fracture Fixation Featuring the Arthrex Trauma Mini Fragment System

Speaker  My name is Mitch Obi. I'm an orthopaedic trauma surgeon at Washington University in Saint Louis, Missouri. And we're going to be talking about patellar fracture fixation. So for this particular patellar fracture pattern, this is a technique that I like to utilize in a 2.7mm t plate. As you will see, as this plate is contoured, it allows for orthogonal fixation and also helps to accommodate patients who have inferior pole comminution, which will be the bottom portion of the T. So we'll grab 270 plates and we will cut it to the appropriate length. There tends to be usually about six holes on the vertical limb of the T to accommodate an appropriate length of this plate. And you can cut this with the cutter that is included in the set. And you can see that this provides a rounded edge. So there aren't sharp edges when applying the plate. And so the next thing that we will do is we're going to bend this portion of the plate at about 90 degrees. And this is going to be the portion of the plate that sits underneath the inferior pole to help support all those inferior pole comminution fragments and compress them up to the intact superior pole. And you can again utilize the benders that are provided to you into the set, and just very gently start to make this 90 degree bend. You want to make sure that you don't go too sharply, as it may crack or disrupt the integrity of the plate. So just kind of slowly making that bend over multiple different passes until you're left with a contour that you're happy with. Speaker  Okay, so that completes the first portion of the contouring. And then the second portion of the contouring is going to be bending this inferior limb of the plate so that it really will contour around the inferior pole of the patella. And you can do this with a variety of different benders. I tend to use the pliers that are in the set, and you can just put a gentle bend through the second hole on each side. As you can see that that will then bend around and cup that portion of the inferior pole of the patella. Now that our dissection has been completed and everything has been appropriately exposed, reduced and then secured in place with these Steinmann pins, we can now proceed with applying the plate. We will place the plate through the vertical split in the patellar tendon that we made, so that it will sit snug up on the inferior pole of the patella as such. And then oftentimes what I'll do is I'll take a small point reduction tenaculum, which is in the set, and I will utilize that in the top hole of the plate to just tension it up proximal to help a little bit with keeping the plate secure. And so it should look a little bit something like that. Once that is completed, then we can proceed with placing our fixation. So with a two zero drill we'll drill through the middle hole in the caudal aspect of the plate in line with the patella up to the superior pole. Speaker  And so a good option for this initial first screw is the 2.7mm crew lock screw, which is a bit of a hybrid screw mix between a cortical in a way, and a locking screw. And this will allow for interfragmentary compression as well as the head of the screw locking into the plate to secure the stabilization. Then, once the middle screw has been placed. You can place additional screws throughout the bottom aspect of the plate, and I tend to go with the middle screw and then the two outer screws to make sure it appropriately captures everything. Okay. And at this point, you can sequentially tighten all the screws if needed to further compress everything down. And also, now that the fracture is ultimately stabilized with three screws, we can proceed with taking these wires out. Just so there's a little bit less traffic within the patella for the rest of your implants. And then you can proceed with placing one additional screw if you so choose, up this final hole in the middle. At this point, we should have completed our fixation throughout the caudal aspect of the plate, and now we can proceed with placing additional screws in orthogonal fashion through the vertical limb of the plate. Which screw holes you choose depends a little bit on where the fracture lines are. Typically these bottom two. You may not be able to get them. Screws in those holes just due to fractures being throughout the inferior pole of the patella. Speaker  So just be cognizant of that. And then additionally you're going to have screws going through this caudal aspect of the plate vertically up the patella. So you may need to aim one way or the other to make sure that these screws miss the implants. And these screws really will then nicely compress the plate also down to bone decrease in implant prominence. And that should complete your fixation of the fracture. So here we have final orthogonal AP and lateral X-rays that we use to assess the reduction, as well as the safety and location of all the implants. When taking a look at these, particularly on the lateral, you want to be critical to ensure that all implants remain extra articular and in this case it did so. Overall satisfactory fixation construct. The Arthrex mini fragment system has really become the workhorse for me and all of my patellar fracture cases, and I really like their implants for a number of reasons, and one being the number of different plate geometries and lengths, as well as the malleability of their plates. How they'll contour down very nicely down to bone, which is a pretty high concern in patella fractures. There's a lot of implants on the market, tend to be a little bit more prominent and can cause symptoms postoperatively. And so I can really decrease that with this particular system. And other advantages are their screw lengths as well as their 2.7mm crew locks, which are very helpful for the additional intraoperative compression as well as their locking capabilities.

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Patellar Fracture Fixation Featuring the Arthrex Trauma Mini Fragment System

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