In the past some surgeons used a transverse approach to the patella. This is not recommended as wound healing is frequently a problem. Additionally, should reconstructive knee surgery be required later in life, a transverse pre-patellar scar may compromise healing.
Parapatellar incisions are also possible, especially in the case of an open fracture. A medial parapatellar arthrotomy is made if it is necessary to inspect the knee joint and intraarticular surgery can still be performed as needed.