Surgical management of neglected fractures of the patella.

Between April 1996 and May 2002, 22 people (18 men, 4 women) were treated for neglected fractures of the patella at our hospital. The median patient age was 43 (range 22-55) years. The majority of the fractures were caused by a direct fall on the knee. In all they comprised 18 transverse, 2 comminuted and 2 lower pole fractures, most of which had been treated by traditional methods initially. The median time between injury and surgery was 3 (range 2-6.5) months. Treatment methods in the orthopaedic department included tension band wiring in 16 cases, tension band wiring with cerclage in 3 cases and patellectomy in 3 cases. Results were evaluated after a median follow-up period of 5.5 (range 2-9) years and were based on Bostman criteria. Excellent results were achieved in 5 and good results in 15 cases. The poor results in two cases were due to infection and implant failure. Surgical treatment of neglected fractures of patella can thus lead to favourable outcomes.