{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T20:26:03Z","timestamp":1793132763739,"version":"4.5.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Orthop Surg Traumatol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To determine the fixation failure rate of the variable-angle (VA) locking patella plate and to evaluate whether supplemental augmentation reduced the risk of fixation failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective comparative cohort study was performed at a Level I trauma center between January 2021 and June 2025. Adult patients with OTA\/AO 34\u00a0C patella fractures treated with a VA locking plate with or without augmentation and \u2265\u20093 months of follow-up were included. Augmentation was defined as additional plates, independent screws, cerclage wire, heavy non absorbable sutures, or suture anchors that were used to supplement fixation and\/or reinforce the inferior patellar pole or extensor mechanism. The primary outcome was fixation failure; secondary outcomes included mode of failure, infection and symptomatic implant removal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-four patients were included (17 VA-only, 17 VA\u2009+\u2009augmentation). Groups were comparable for age, sex, Charlson Comorbidity Index, OTA\/AO subclassification, open fracture status and follow-up duration (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). The overall fixation failure rate was 2.9% (1\/34), occurring at the distal fixation interface in the augmented group. There was no significant difference in failure rate between groups (VA-only 0.0% vs. VA\u2009+\u2009augmentation 5.9%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.0). One patient in the VA group suffered a fracture-related infection and one patient in the VA\u2009+\u2009augmentation cohort had a suture abscess. One patient in the VA\u2009+\u2009augmentation cohort required hardware removal for symptomatic hardware. All remaining patients healed without complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Variable-angle locking plate fixation of AO\/OTA 34\u00a0C patella fractures was associated with low rates of early fixation failure and symptomatic hardware removal. With only a single documented fixation failure, the study was underpowered to draw conclusions regarding the protective role of augmentation on fixation failure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00590-026-04864-1","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T05:48:04Z","timestamp":1784526484000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Low early fixation failure rates with variable-angle locking plate fixation of AO\/OTA 34\u00a0C patella fractures: a retrospective cohort study"],"prefix":"10.1007","volume":"36","author":[{"given":"Benyamin","family":"Dadpey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Bonnyman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hevatib","family":"Mehmood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7065-9551","authenticated-orcid":false,"given":"William T.","family":"Kent","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"4864_CR1","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1080\/17453674.2019.1698148","volume":"91","author":"V Vestergaard","year":"2019","unstructured":"Vestergaard V, Pedersen AB, Tengberg PT et al (2019) 20-year trends of distal femoral, patellar, and proximal tibial fractures: a Danish nationwide cohort study of 60,823 patients. 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