Patella is a very useful bone which helps in climbing activities. Hence comminuted Intra Articular Fractures of Patella merit attention to regain quadriceps power. One school believes in patellectomy for such fractures, while other, believes in retaining the patella, even if it is comminuted, realigning and stabilising it with wires loops and K wires.

Results are better if the patella is preserved because it functions as a important pulley for the quadriceps mechanism. Hence the function of quadriceps is better and there are less chances of quadriceps lag after repair of patella rather than after patellectomy.

Special X - Rays

Skyline view after reconstruction to see the articular congruity.

Non operative treatment is useful only for undisplaced stellette fractures. Once the patellar retinacula are torn, the quadriceps force pulls the fragments apart and hence non operative treatment will lead to gap non union and quadriceps lag, resulting in difficulty in climbing stairs and frequent falls due to unstable knee.