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The integrity of the patella is pivotal for the efficient functioning of the knee extensor mechanism. Thus, patella fracture management cannot be neglected and utmost priority should be determined for its preservation and maintenance of knee functioning. Tension band wiring (TBW) is the most widely and commonly used mode of fixation of patella fractures with consistently favourable outcomes. However, the complications associated with the same could be challenging and may compromise the integrity of the patella. This case report highlights the salvage of the failed TBW for a patella fracture with biomechanically stronger angular stable Star-shaped patella plate.

Ankylosing spondylitis (AS) is an underdiagnosed inflammatory condition in the initial stages of disease that can cause vertebral fractures in young adults after trivial trauma. Hence, low-energy spinal fractures in young patients must be carefully evaluated to exclude AS as the treatment protocol (fixation levels, period of immobilization) may change drastically if AS is diagnosed. Here, we present cases of 3 patients who presented at emergency after low-velocity spinal trauma and diagnosed as AS during workup for fracture management. This cases series indicates underdiagnosis of AS in general population as well as importance of strong suspicion of AS in low-energy spinal fractures in the younger age-group.

Fractures of the supracondylar and intercondylar region of the distal femur usually result from high velocity injury that is uncommonly associated with violation of the integrity of the extensor mechanism. The consequences of missed quadriceps injury associated with a distal femur fracture are devastating. The present case report illustrates the importance of recognizing the rare association of quadriceps tear with distal femoral fractures, an appropriate surgical approach to repair the tear as well as fixation of fracture, and a protocol of postoperative rehabilitation to achieve a successful outcome.