Recently the incidence of the patellar fracture has been increasing because of frequent traffic accidents and industrial accidents, and its treatment is considered very important due to the involvement of the articular suface occurs in most of the cases. Comminuted displaced fractures of the patella which are difficult to reduce accurately and to get stable internal fixation, may lead to traumatic osteoarthritis, chondromalacia, extension lag and limited ROM of the knee joint.

The retrospective review was undertaken of 49 patients with patellar fractures treated by surgical methods and a follow up of more than 1 year at the Department of Orthopaedic Surgery at Maryknoll Hospital between Aug. 1987 and Jan. 1994.

The findings were as follows:

1. Most fractures were encountered in man from twenties to forties.

2. The most common cause of fractures was traffic accident, followed by slip down or fall down.

3. Comminuted fracture was the most common type in this series.

4. Large separated fragments of the patella should be accurately reduced with rigid fixation in the rationale of the intraarticular fracture.

5. The most favorable results were obtained by Modified Tension Band Wiring with supplementary oircurnferential wiring for comminuted fractures and the result was superior to other operative methods.