{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T13:12:57Z","timestamp":1778850777142,"version":"3.51.4"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES:<\/jats:title>\n                    <jats:p>To determine if initial vertical fracture displacement affects postoperative outcomes after operative treatment of patella fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Prognostic retrospective study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Single multisite urban academic institution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient Selection Criteria:<\/jats:title>\n                    <jats:p>Included were patients aged \u226518 years who underwent open reduction internal fixation of a patella fracture (AO\/OTA 34A-C) with minimum 6-month follow-up and complete trauma knee x-ray series. Vertical fractures and those without significant vertical displacement (&lt;2 mm) were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome Measures and Comparisons:<\/jats:title>\n                    <jats:p>Initial vertical fracture displacement was recorded. Follow-up data included knee range-of-motion and postoperative complications: nonunion, fracture-related infection, hardware failure, suspected fracture\u2013related infection, knee contracture, inferior sleeve displacement, and venous thromboembolism events. Comparisons were made between the initial amount of displacement and postoperative complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Two hundred twenty-nine patients with a median follow-up duration of 12 months (Interquartile range: 6\u201314) were included. The mean age was 61.2 \u00b1 15.1 years, body mass index was 25.4 \u00b1 4.7 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , and 69.0% (n = 158) were female. Orthopaedic Trauma Association fracture classification was 35.4% C1, 32.3% C3, 17.9% C2, and 14.4% A1. Fixation methods included 63.8% tension band wiring, 17.9% suture repair, 13.5% plate and screws, and 4.8% screws with suture. Thirty-three (14.4%) patients sustained complications. The mean displacement was significantly higher in patients who developed complications (21.6 mm \u00b1 15.0 mm vs. 14.8 mm \u00b1 10.1 mm,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.018), particularly for nonunion (29.8 mm \u00b1 13.5 mm vs. 15.1 mm \u00b1 10.6 mm,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) and hardware failure (30.8 mm \u00b1 12.0 mm vs. 15.4 mm \u00b1 10.9 mm,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Suture-only and screw-with-suture fixation had higher nonunion rates (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.004,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.005) than other fixation methods independent of displacement. Initial displacement predicted nonunion and hardware failure (AUROCs = 0.818 and 0.838). Youden Index thresholds of &gt;26.6 mm and &gt;21.7 mm identified patients at increased risk for nonunion and hardware failure. Each millimeter increase in displacement raised nonunion and hardware failure risk by 14.9% (OR = 1.1,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003) and 14.6% (OR = 1.1,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>This study supports the future use of initial vertical fracture displacement as a prognostic tool for nonunion and hardware failure after patella open reduction internal fixation. Displacement &gt;2 cm placed patients at high risk for these complications. Nonunion rates were higher in both suture-only and screw-with-suture fixation when compared with other fixation constructs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LEVEL OF EVIDENCE:<\/jats:title>\n                    <jats:p>Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/bot.0000000000003149","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T14:00:38Z","timestamp":1769522438000},"page":"307-313","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Initial Patella Vertical Fracture Displacement Is a Predictor of Nonunion and Hardware Failure"],"prefix":"10.1097","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6064-1127","authenticated-orcid":false,"given":"Alexander M.","family":"Lashgari","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amelia R.","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George W.","family":"Monroe","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6609-2065","authenticated-orcid":false,"given":"Abhishek","family":"Ganta","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and"},{"name":"Department of Orthopedic Surgery, Jamaica Hospital Medical Center, Queens, NY."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8488-2677","authenticated-orcid":false,"given":"Sanjit","family":"Konda","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and"},{"name":"Department of Orthopedic Surgery, Jamaica Hospital Medical Center, Queens, NY."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0341-7683","authenticated-orcid":false,"given":"Kenneth A.","family":"Egol","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20260515","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1007\/s11999-010-1537-8","article-title":"Patellar fractures","volume":"469","author":"Scolaro","year":"2011","journal-title":"Clin Orthop Relat Res."},{"key":"R2-20260515","doi-asserted-by":"crossref","first-page":"w20165","DOI":"10.4414\/smw.2020.20165","article-title":"Practical guidelines for the treatment of patellar fractures in 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