This group includes patients with inferior pole patellar fractures (IPPF) treated using anchor suture fixation combined with titanium cable cerclage. The intervention involves securing fracture fragments with anchors to provide stable fixation, reinforced by a titanium cable cerclage for additional stability. This method is intended to reduce hardware-related complications while maintaining biomechanical stability and supporting functional recovery. The outcomes for this group include operative time, postoperative knee range of motion, incidence of complications, need for secondary surgery, and functional scores such as the Bostman score.

This group includes patients with inferior pole patellar fractures (IPPF) treated using Kirschner-wire tension band combined with patellar cerclage (TBW-LP group). This intervention involves the placement of Kirschner wires to create a tension band construct across the fracture site, stabilizing the fragments, with additional support provided by a cerclage wire. This method is widely used in clinical practice due to its simplicity and cost-effectiveness. The study evaluates key outcomes for this group, including operative time, knee range of motion, incidence of postoperative complications such as hardware irritation or infection, and functional recovery based on Bostman scores. This group serves as a comparison to newer techniques like anchor suture with titanium cable cerclage.

This intervention involves the use of **anchor suture fixation combined with titanium cable cerclage** for the treatment of inferior pole patellar fractures (IPPF). The anchor suture provides stable fixation of fracture fragments by anchoring directly into the bone, while the titanium cable cerclage offers additional reinforcement around the patella to enhance stability and minimize fragment displacement. This method is specifically designed to address the limitations of traditional Kirschner-wire tension band techniques, such as hardware irritation and infection, by using biocompatible and low-profile materials.

The final knee range of motion is assessed to evaluate the functional recovery of patients following surgical treatment for inferior pole patellar fractures (IPPF). This measure includes the degree of flexion and extension achieved during follow-up, as documented through physical examination and patient self-reports. The range of motion is compared between the two intervention groups to determine the effectiveness of each treatment method in restoring knee functionality and mobility. Outcomes are measured and analyzed based on clinical standards and benchmarks for knee rehabilitation.

The incidence of secondary surgery is defined as the number of patients who require an additional surgical procedure related to the treatment of inferior pole patellar fractures (IPPF) within the follow-up period. This includes procedures to address complications such as hardware irritation, infection, nonunion, malunion, or mechanical failure of the initial fixation. The data will be compared between the two intervention groups to evaluate the durability and long-term effectiveness of each surgical technique. This measure provides critical insights into the need for re-intervention and overall treatment success.

Postoperative complications include any adverse events or clinical issues occurring as a result of the surgical treatment for inferior pole patellar fractures (IPPF) within the follow-up period. These complications may include, but are not limited to, hardware irritation, infection, wound dehiscence, delayed union, nonunion, or malunion. Data will be collected from medical records and follow-up visits to identify the frequency and types of complications in each intervention group. The results will be analyzed to compare the safety profiles of the anchor suture with titanium cable cerclage and the Kirschner wire tension band with cerclage cable techniques. This outcome is critical for assessing the overall safety and effectiveness of each surgical approach.

Operative time is defined as the total duration of the surgical procedure, measured from the initial incision to the completion of wound closure. This outcome measure evaluates the efficiency of the surgical intervention and provides insights into the complexity and technical demands of each technique. Operative time is compared between the two groups (anchor suture with titanium cable cerclage vs. Kirschner wire tension band with cerclage cable) to assess any significant differences in surgical duration. This metric is particularly relevant in evaluating the practicality and feasibility of each intervention in clinical practice.