Nonoperative treatment of widely displaced patella fractures.

Eighteen patients with displaced patellar fractures were treated nonoperatively. All of the fractures were displaced by at least 1 cm. Ambulation and knee flexion were encouraged as soon as pain permitted. Twelve of the patients were limited in their activities by medical illnesses. Six of these patients died, and the remaining patients underwent follow-up for 2 years. No patient had severe pain, and only three had acquired significant limitations in their activities from their fractures. Nine patients had either minimal or moderate activity restrictions. There were no complications from treatment. Nonoperative treatment is a reasonable option for displaced fractures of the patella, particularly in patients whose activities are limited by chronic illness. Better results, however, are possible with operative treatment.