OBJECTIVE : To evaluate the clinical efficacy of operation methods with or without a turned-over patella for treatment of C3-type patellar fractures. METHODS : A total of 68 patients with C3-type patellar fractures undergoing open reduction and internal fixation were retrospectively selected and treated with a turned-over patella surgery (turned-over patella group, n = 30) or conventional therapy without turning over the patella (conventional group, n = 38). The intraoperative and postoperative indicators of the two groups were assessed and comparatively analyzed. RESULTS : The bedridden time was significantly shorter in the turned-over patella group than in the conventional group (P = 0.002), while the range of motion (ROM) of knee joint was significantly higher in the turned-over patella group (P = 0.044). The Lysholm score was slightly higher in the turned-over patella group than in the conventional group, but the difference was not statistically significant (P = 0.055). No significant difference was observed between the two groups in terms of the operation time (P = 0.096), intraoperative blood loss (P = 0.543), time of weight bearing (P = 0.312), fracture healing time (P = 0.272), or complications (P = 1). CONCLUSIONS : The turned-over patella operation method exhibited some superiority to conventional reduction-fixation approach for treatment of C3-type patellar fractures in terms of efficacy and safety by enlarging the ROM of the knee joint and promoting functional recovery.