[Long-term results of surgical management of patellar fractures]

Between 1973 and 1989, 129 patients with 135 fractures of the patella were treated operatively. More than two-thirds of these patients were younger than 40 years at the time of the accident. The main cause of trauma was a traffic accident in 65.9%. Sixty patients had polytraumata. There were 74 comminuted, 28 transverse, 17 starlike, 10 longitudinal and 6 fractures with one large fragment. Eighty-two patients with 85 fractures were followed up after 8.4 years on average (1.2-16.3 years). The overall results were excellent or good in 64.7%, fair in 18.8% and poor in 16.5%. The best results were seen in transverse fractures after modified tension-band wiring using two longitudinal K wires, and in longitudinal fractures applying screws. Sixty-three percent of the fair and poor results were seen after osteosynthesis of comminuted fractures. In these cases primarily partial or complete patellectomy seems to be indicated instead of just insufficient reconstruction of the retropatellar face. Early functional physiotherapy is very important for all kinds of patellar fractures to gain full range of motion.