Objective To investigate the effectiveness of three-needle and two-cable structure in the treatment of inferior patellar pole avulsion fractures. Methods A clinical data of 62 patients with inferior patellar pole avulsion fractures who were admitted between January 2023 and December 2023 and met the selection criteria was retrospectively analyzed. Among them, the fractures were fixed with three-needle and two-cable structure in 32 patients (observation group) and traditional steel wire tension band in 30 cases (control group). There was no significant difference in the baseline data of age, gender, side of the affected limb, cause of injury, and disease duration between the two groups (P>0.05). The operation time, fracture healing and healing time, patellar height (Insall-Salvati index), occurrence of complications, knee range of motion, and Böstman score at last follow-up were compared between the two groups. Results The operation time of the observation group was significantly shorter than that of the control group (P<0.05). Patients in both groups were followed up 6-12 months (mean, 10.4 months). X-ray re-examination showed that all fractures healed, and the fracture healing time was significantly shorter in observation group than in control group (P<0.05). During follow-up, the complications occurred in 2 cases (6.25%) in observation group and 9 cases (30.00%) in control group, and the difference in the incidences was significant (P<0.05). At last follow-up, the range of motion and Böstman score of the knee joint in observation group were superior to control group (P<0.05). Conclusion Compared with the traditional steel wire tension band fixation, the three-needle and two-cable structure is used to treat the inferior patellar pole avulsion fractures with firm fixation, which allows the knee joint to move early after operation and is conducive to the recovery of knee joint function.