Results of treating 238 transverse, longitudinal, and osteochondral fractures of the patella are reviewed. Of these, 89 patients had partial patellectomy and extensor mechanism reconstruction. After an average follow-up of four years, functional results have been excellent; there have been no late patellectomies and traumatic arthritis has not developed. Total patellectomy is recommended only when the entire patella is so severely comminuted that none of it can be used as part of the extensor mechanism of the knee.