Background <p>Krackow suturing and suture bridge technique was compared with Kirschner-Wire (K-wire) tension band and patella cerclage for the fixation of inferior pole patella fracture.</p> Methods <p>This was a retrospective study of 47 patients with inferior pole patella fractures who underwent fixation procedures at our hospital between January 2019 and May 2022, of whom 25 had Krackow suturing combined with the suture-bridge technique (GROUP 1), and 22 received a K-wire tension band combined with patellar cerclage (GROUP 2). We compared the operative time, reoperation rate, Böstman score, knee range of motion (ROM), fracture-healing time, Insall–Salvati index, complications and hospital expenses between the two groups.</p> Results <p>The average follow-up period was 23.1 ± 5.8 months. The complication and reoperation rates in the GROUP 2 were significantly higher than those in the GROUP 1 (<i>P</i> = 0.023 and <i>P</i> &lt; 0.001). While the GROUP 1 has lower hospital expenses than GROUP 2 (<i>P</i> &lt; 0.001). However, significant differences were not found regarding the Böstman score, knee ROM, Insall–Salvati index, fracture-healing time, and operation time between the two groups.</p> Conclusions <p>Both Krackow suturing combined with the suture-bridge technique and the K-wire tension band technique can achieve comparable clinical efficacy in stably fixing inferior patellar pole fractures, subsequently allowing an early commencement of rehabilitation exercise, while the suture-bridge technique can also reduce the incidence of complications, hospital expenses and the need for reoperation surgery.</p> Trial registration <p>This study was registered on <a href="https://www.chictr.org.cn">https://www.chictr.org.cn</a> (registration No. ChiCTR2300072069, 2023/06/01, retrospectively registered). Informed consent was obtained from all individual participants included in the study.</p>