OBJECTIVETo compare clinical effects of different fixations in order to provide the best therapeutic choice for comminuted patellar fractures.

METHODSFrom February 2003 to June 2009, 56 patients with comminuted patellar fractures were treated with three methods of fixation. Of them, 18 patients (group A) were treated with Kirschner-wire with steel wire fixation, there were 9 males and 9 females, ranging in age from 32 to 52 years with an average of (47.62 +/- 4.82) years; 13 patients (group B) with circular silk thread fixation and plaster immobilization, there were 3 males and 10 females,ranging in age from 38 to 65 years with an average of (48.58 +/- 8.28) years; 25 patients (group C) with memory alloy patella holder fixation, there were 9 males and 16 females, ranging in age from 32 to 68 years with an average of (48.36 +/- 9.59) years. According to criteria of Böstman, eight indexes were compared, including the range of motion of the knee, pain, walking and so on.

RESULTSAll patients were followed up from 8 to 26 months with an average of 15.6 months. All the fractures healed. The Böstman scoring of group A, B, C were respectively 26.00 +/- 4.6, 22.08 +/- 5.31, 26.44 +/- 3.77. The clinical effects of group A and C were better than that of group B (P < 0.05).

CONCLUSIONThe method of Kirschner-wire with steel wire fixation or memory alloy patella holder fixation can obtain satisfactory effects in treating comminuted patellar fractures because of steady fixation and early function recovery.