Plateau and Patella: A Framework for Ipsilateral Injury Fixation.

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.