Partial patellectomy for patellar fracture: tension band wiring and early mobilization.

Partial patellectomy for patellar fracture was performed in 56 patients. The patellar tendon-to-bone repair was reinforced by a figure-of-eight tension band wire loop from the patella down to the tibial tubercle. Early mobilization and weight bearing of the injured extremity was initiated within the first postoperative week. Thirty-one patients treated between 1977 and 1980 were reviewed retrospectively at an average of 22 months (range 3-49 months). Twenty-five patients treated between 1984 and 1987 were studied prospectively: Knee function was monitored at 5.5 weeks after injury, at 3 months, and at final follow-up at a mean of 25 months (range 8-48 months). Satisfactory knee function was recovered by 3 months. No disruption of knee extensor mechanism was encountered. Complications were frequent in the retrospective series. A high percentage of patients had radiological osteoarthritis after the fracture. This could be due to alteration of the patellofemoral articulation after part of the patella was excised.