Can You Break Your Knee Cap and Not Know It?

The patella covers and protects the knee

A patellar fracture is a break in the patella, or kneecap, the pocket-size bone that sits at the front of your knee. Because the patella acts as a shield for your genu joint, it is more probable to break if you autumn directly onto your knee or hit it against the dashboard in a car accident. A patellar fracture is a serious injury that can make it difficult or even impossible to straighten your knee or walk.

Some unproblematic patellar fractures can be treated by wearing a cast or splint until the bone heals. In most patellar fractures, still, the pieces of bone movement out of identify when the injury occurs. For these more than complicated fractures, surgery is needed to repair the kneecap.

What is the anatomy of the patella?

The patella is a small bone located in front end of the knee articulation — where the thighbone (femur) and shinbone (tibia) meet. It protects the knee and connects the muscles in the front of the thigh to the tibia.

The ends of the femur and the undersides of the patella are covered with a smoothen substance called articular cartilage. This cartilage helps the basic glide easily along each other every bit yous move your knee.

What causes a patellar fracture?

Patellar fractures are about oftentimes caused by:

• Falling directly onto the knee
• Receiving a sharp blow to the knee, such as might occur during a caput-on vehicle collision if your kneecap is driven into the dashboard

The patella can too be fractured indirectly. For example, a sudden wrinkle of the quadriceps muscle in the knee can pull apart the patella.

What are the symptoms of patellar fracture?

The most common symptoms of a patellar fracture are pain and swelling in the front of the knee. Other symptoms may include:

• Bruising
• Disability to straighten the knee or keep it extended in a direct leg raise
• Inability to walk

What are the dissimilar types of patellar fractures?

Illustration and 10-ray testify a vertical, stable fracture of the patella.

In this type of fracture the pieces of bone may remain in contact with each other or exist separated past just a millimeter or two. In a stable fracture, the basic usually stay in place during healing.

Analogy and ten-ray prove a forepart (left) and side (correct) view of a two-part fracture across the patella (transverse fracture) with slight displacement between the cleaved pieces of bone.

In a displaced fracture, the cleaved ends of the bone are separated and practice non line up correctly. The normally polish joint surface may accept too moved. This type of fracture oftentimes requires surgery to put the pieces of bone back together.

A comminuted fracture

In this type of fracture, the bone shatters into three or more pieces. Depending on the specific pattern of the fracture, a comminuted fracture may be either stable or unstable.

Open up fracture. In an open fracture, the os breaks in such a way that os fragments stick out through the skin or a wound penetrates down to the os. An open up fracture often involves damage to the surrounding soft tissues and may take a longer time to heal. Open up fractures are particularly serious because, once the skin is broken, in that location is a higher risk for infection in both the wound and the bone. Immediate treatment is required to prevent infection.

How is a patellar fracture diagnosed?

After discussing your symptoms and medical history, your doctor will examine your knee. The edges of the fracture tin often be felt through the skin, particularly if the fracture is displaced.

During the examination, your physician volition bank check forhemarthrosis. In this condition, claret from the fractured os ends collects inside the joint infinite, causing painful swelling. If you lot have a large amount of claret in your knee, your medico may drain information technology to help salve your hurting. Your md volition also order x-rays to assistance diagnose your fracture.

How is a patellar fracture treated without surgery?

If the pieces of bone are non out of identify (displaced), you may not need surgery. Your doctor may utilise a cast or splint to proceed your knee direct and assist prevent motion in your leg. This will proceed the broken ends of bone in proper position while they heal.

Depending upon your specific fracture, you may be allowed to bear weight on your leg while wearing a bandage or brace. With some fractures, however, weight begetting is not allowed for 6 to 8 weeks. Your doctor will talk with yous about restrictions on weight bearing.

How is a patellar fracture treated with surgery?

The type of procedure performed depends on the type of fracture yous take. Earlier the surgery, your doctor will discuss your process with yous, too every bit whatever potential complications.

Transverse Fracture

In this illustration and x-ray, a figure-of- eight tension band has been used to hold a transverse fracture together.

These two-part fractures are most oftentimes stock-still in identify using screws or pins and wires and a "figure-of-viii" configuration tension band. The figure-of-eight band presses the two pieces together. This process is best for treating fractures that are located near the center of the patella. Fracture pieces at the ends of the kneecap are too pocket-sized for this procedure. Breaks that are in many pieces can be over compressed by the tension band.

Another arroyo to a transverse fracture is to secure the basic using small screws or small screws and minor plates.

Comminuted fracture.

In some fractures, the top or, more likely, the bottom of the patella is broken into several modest pieces. This type of fracture occurs when the kneecap is offset pulled apart from the injury, and is and then crushed when the patient falls on information technology.

Because the os fragments are besides pocket-sized to be fixed back into place, your medico volition remove them. He or she volition then attach the loose patellar tendon back to the remaining patellar bone.

If the kneecap is broken in many pieces at its center and the pieces are separated, your doctor may utilise a combination of wires and screws to ready it. Removing pocket-size portions of the kneecap that cannot be reconstructed may as well have expert results. Complete removal of the kneecap is a last resort in treating a comminuted fracture.

What is recovery like after a patellar fracture?

Rehabilitation

Whether your treatment is surgical or nonsurgical, rehabilitation will play a vital role in getting you dorsum to your daily activities. Because treatment for a patellar fracture can sometimes crave keeping your leg in a cast so that you are unable to move it for a long period of fourth dimension, your knee may become potent and your thigh muscles may go weak.

During rehabilitation, your doctor or a physical therapist volition provide you with specific exercises to help:

• Better range of motion in your articulatio genus
• Strengthen your leg muscles
• Decrease stiffness

Weight Bearing

Your doc will tell yous when you can begin to bear weight on your leg. Initial weight-bearing exercise is ordinarily express to gently touching your toe to the floor. As your injury heals and your muscles strengthen, yous will gradually be able to put more than weight on your leg.

How long does information technology take to recover from a patellar fracture?

This will depend upon a number of factors, including:

• The severity of your injury
• Whether your treatment was surgical or nonsurgical
• The time needed for rehabilitation

Virtually patients will exist able to return to their normal activities within 3 to half-dozen months. For patients with severe fractures recovery may take longer

Your medico may suggest some lifestyle changes to aid protect your human knee and prevent futurity problems. This may include avoiding activities that involve repetitive deep knee bending or squatting. Climbing stairs or ladders should be avoided, as well.

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Source: https://www.bmc.org/patient-care/conditions-we-treat/db/patellar-kneecap-fracture

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