[Partial and total patellectomy as treatment of comminuted patella fracture]

When accurate reduction and stable fixation cannot be achieved in comminuted patellar fractures, degenerative changes in the patellofemoral joint can cause troublesome complaints. Our results show that partial or total patellectomy can produce a very good percentage of satisfactory results. In spite of several biomechanical studies that demonstrated the reduced efficiency of the quadriceps mechanism after partial and total excision of the patella, most patients achieved good or excellent results after a long follow-up period. All patients showed decreased isokinetic performance of the quadriceps muscle. There was no clear correlation between the clinical score and the data on isokinetic performance. Patellofemoral or femorotibial osteoarthritis and calcifications in the patellar ligament did not lead to an unsatisfactory clinical result.