• Kai Fehske, Markus T Berninger, Lena Alm, Reinhard Hoffmann, Johannes Zellner, Clemens Kösters, Stefan Barzen, Michael J Raschke, Kaywan Izadpanah, Elmar Herbst, Christoph Domnick, Jan Philipp Schüttrumpf, Matthias Krause, and Komitee Frakturen der Deutschen Kniegesellschaft (DKG).
• Klinik und Poliklinik für Unfall‑, Hand‑, Plastische- und Wiederherstellungschirurgie, Universitätsklinikum Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Deutschland. Fehske_k@ukw.de.
• Unfallchirurg. 2021 Oct 1; 124 (10): 832-838.

BackgroundThe treatment of patella fractures is technically demanding. Although the radiological results are mostly satisfactory, this often does not correspond to the subjective assessment of the patients. The classical treatment with tension band wiring with K‑wires has several complications. Fixed-angle plate osteosynthesis seems to be biomechanically advantageous.ObjectiveWho is treating patella fractures in Germany? What is the current standard of treatment? Have modern forms of osteosynthesis become established? What are the most important complications?Material And MethodsThe members of the German Society for Orthopedics and Trauma Surgery and the German Knee Society were asked to participate in an online survey.ResultsA total of 511 completed questionnaires were evaluated. Most of the respondents are specialized in trauma surgery (51.5%), have many years of professional experience and work in trauma centers. Of the surgeons 50% treat ≤5 patella fractures annually. In almost 40% of the cases preoperative imaging is supplemented by computed tomography. The classical tension band wiring with K‑wires is still the preferred form of osteosynthesis for all types of fractures (transverse fractures 52%, comminuted fractures 40%). In the case of comminuted fractures 30% of the surgeons choose fixed-angle plate osteosynthesis. If the inferior pole is involved a McLaughlin cerclage is used for additional protection in 60% of the cases.DiscussionThe standard of care for patella fractures in Germany largely corresponds to the updated S2e guidelines. Tension band wiring is still the treatment of choice. Further (long-term) clinical studies are needed to verify the advantages of fixed-angle plates.© 2020. The Author(s).

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