Simultaneous Open Fractures of Both Patellae: A Case Report and Review of the Literature.

We present the case of an 18-year-old male who presented following a high-energy motor vehicle accident with direct trauma to both flexed knees. Clinical examination revealed bilateral open anterior knee wounds with exposed bone fragments and intact distal neurovascular status. Plain radiographs confirmed bilateral displaced transverse patellar fractures (Gustilo-Anderson type II). The patient underwent urgent single-stage open reduction and internal fixation of both patellae under general anesthesia. Thorough debridement and pulsed-saline lavage were performed bilaterally, followed by anatomical reduction and tension-band wiring fixation. The medial and lateral retinacula were repaired bilaterally. Postoperative radiographs confirmed satisfactory reduction. Early protected range-of-motion rehabilitation was initiated, and final follow-up at 16 months demonstrated uncomplicated healing, with full active bilateral knee extension (0°), flexion of 135° bilaterally, and a Lysholm Knee Score of 95/100. Simultaneous bilateral open fractures of the patellae represent a rare and severe orthopedic injury, disrupting both extensor mechanisms while introducing the immediate infectious risks associated with open contamination. Bilateral simultaneous patellar fractures are rare, and open bilateral injuries are even more exceptional. We report a case of this uncommon trauma pattern and review the relevant literature.