[Patella fragmentation in cerebral palsy].

In 16 patients with cerebral palsy 23 painful fragmentations at the lower pole of the patella were observed and surgically removed. In all cases pain was relieved immediately. Patellar fragmentations usually appeared in children between 12 and 16 years, in males twice as often in females. Patella alta was seen in all cases. All patients were walkers, however, 4 with hand supports only. In 14 of the 16 children there was knee flexion deformity during gait of 20-60 degrees. The cause of fragmentation is regarded to be overload of the quadriceps muscle in a juvenile bone condition, and is related to the "jumper's knee" due to fatigue. In 9 of the 16 patients an achilles tendon lengthening had been performed several years before, without overcorrection. All patients were of reasonable intelligence.