Restoration of Knee Function After Tibial Tubercle Proximalization for Infrapatellar Contracture Syndrome Following Patellar Fracture Surgery

髌骨骨折术后胫骨结节近端化治疗髌骨下挛缩综合征后膝关节功能的恢复

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Abstract

Infrapatellar contracture syndrome (IPCS) is a rare but functionally disabling condition characterized by anterior knee fibrosis and patellotibial impingement. We report the case of a 59-year-old woman who developed IPCS after undergoing tension band wiring for a patellar fracture, presenting with pain, quadriceps weakness, and marked patella baja (Insall-Salvati ratio: 0.377). Proximalization of the tibial tubercle by 15 mm restored patellar height and improved knee flexion from 120° preoperatively to 150° at the one-year follow-up. At two years, the patient achieved full squatting and floor sitting (seiza), with no extension lag, quadriceps strength of 86.4 N (contralateral: 96.6 N), and an improved Timed Up and Go score from 12.89 to 6.86 seconds. Tibial tubercle proximalization may be an effective tendon-sparing option for IPCS with patella baja, enabling restoration of patellar height, improved range of motion, and early rehabilitation without direct tendon manipulation.

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