Frequency of sustained patellar tendon injuries in children has increased with rise of popularity of sportive and recreational activities. Mechanism behind this injury is believed to be the increased strain on the tendon due to forced extension of the knee while the leg is flexed [5].
Early diagnosis is usually hindered by acute swelling and pain and for the delayed diagnosis creates need for more complicated surgical methods [6]. Radiological tools could be used to aid the diagnosis.
In total ruptures with the disruption of the extensor mechanism operative techniques such as primary end-to-end repair could be used. Reconstruction with a tendon allograft is reserved for chronic conditions where ruptured ends could not be brought together [7]. Usage of end-to-end suture and fixation of patella with a cerclage wire was reported to have satisfactory outcome post-operatively in traumatic patellar tendon rupture without bony involvement [4]. As Bushnell et al. reported, usage of a suture anchor technique in primary repair improved the functional outcome considerably [8]. According to the tests conducted by Kocadal et al. support with a cerclage wire showed to provide the most biomechanical support compared to other methods. Disadvantages of this procedure is a need for reoperation to remove the wire [9].
Use of achilles tendon allograft for augmentation yielded satisfactory results in massive ruptures such as in case of late repair of bilateral patellar tendon rupture by Muratli et al [6].
No standard postoperative rehabilitation protocol existed in current literature, except of our previous study which addressed rehabilitation after tibial tuberosity fractures [10].
In our case end-to-end suture, reinforcement with a cerclage wire and fixation with footprint anchors were used. In our opinion combination of all three methods was suitable to cover for the wide rupture of patellar tendon and could provide for reduction of the risk of tendon re-rupture. Moreover, usage of footprint anchors in compared to use of staples or K-wire fixation doesn’t require reoperation for implant removal. In the follow-up of our patient, we were able to observe good functional and radiological outcome following our approach.