While physical therapy following the treatment with the Zuggurtung method enables the active flexion movement of the knee joint to enhance bone union at an early stage, the active extension movement may impose stress on the fractured segments toward their separation; thus due caution must be exercised. The treatment outcome of patella Fractures has been improved since the introduction of the Zuggurtung method;however, this method is not always applicable depending on the fracture type, and accordingly, risks of physical therapy would differ between cases treated with and without the Zuggurtung method. This paper reports on the cases of 2 patients with fractures of the distal patella who were not appropriate to the Zuggurtung method. Treatment outcomes similar to those of treatment with the Zuggurtung method were observed by clarifying accompanying risks and aggressively maintaining flexibility and smoothness of the supra-patella tissues during and after knee brace fixation. It was thought essential to proceed physical therapy after considering associated risks based on the details and characteristics of an open reduction and internal fixation (ORIF) performed for each patient’s patella fractures.