Patellar fractures are rare in children and usually result from high-energy trauma. Treatment guidelines generally are the same as for patellar fractures in adults. Between 1942 and 1987, 66 children with patellar fractures were treated. Exclusion of those with < 2-year follow-up, osteochondral fractures, or incomplete records left 24 patients for long-term follow-up. Overall results were good in 13, fair in eight, and poor in three. Children with fractures of the ipsilateral femur and/or tibia and those with comminuted, displaced fractures had the poorest results.