**Core Concept**
A transverse fracture of the patella refers to a break in the patella (kneecap) that occurs across its width, perpendicular to its long axis. This type of fracture can disrupt the extensor mechanism of the knee, leading to difficulties in knee extension and potentially causing patella baja or patella alta.

**Why the Correct Answer is Right**
The treatment of choice for a transverse fracture of the patella is open reduction and internal fixation (ORIF). This involves surgically exposing the fracture site, reducing the fragments to their anatomical position, and stabilizing them with plates, screws, or other implants. The primary goal is to restore the extensor mechanism and allow for early mobilization and rehabilitation. ORIF is preferred over other options because it allows for precise reduction and stable fixation, reducing the risk of complications such as malunion, nonunion, or patellar fragmentation.

**Why Each Wrong Option is Incorrect**
* **Option A:** Nonoperative treatment, such as immobilization in a cast, is not suitable for transverse fractures of the patella due to the high risk of malunion, nonunion, or extensor mechanism dysfunction.
* **Option B:** Patellar tendon realignment or transfer is a separate procedure that may be considered in cases of patellar baja or patellar alta, but it is not the primary treatment for transverse fractures.
* **Option C:** Arthroscopic reduction and fixation may be considered in some cases, but it is not the preferred treatment for transverse fractures of the patella due to the risk of incomplete reduction and instability.

**Clinical Pearl / High-Yield Fact**
In cases of patella fractures, it's essential to assess the integrity of the extensor mechanism and address any associated injuries, such as patellar tendon or quadriceps tendon ruptures.

**Correct Answer: C. ORIF**