The small bone that sits in front of your knee, the patella, also known as the kneecap, can break and cause a patellar fracture. The patella protects your knee joint, making it susceptible to fracture if you fall directly on it or if you bang it against the dashboard during a car accident. A patellar fracture is a serious injury that can make walking or straightening your knee difficult or even impossible.
Wearing a cast or splint while the bone heals is an effective treatment for some straightforward patellar fractures. However, in the majority of patellar fractures, the injury causes the bone fragments to move out of position. Surgery is required to repair and stabilize the kneecap and enable the return of function in these more complex fractures.
Anatomy of Patellar
The thigh bone (femur) and shinbone (tibia) meet at the patella, a small bone in front of the knee joint. It connects the muscles in the front of the thigh to the tibia and safeguards the knee.
Articular cartilage, a smooth material, covers the ends of the femur and the undersides of the patella. When you move your knee, the cartilage allows the bones to move smoothly past one another.
Causes of Patella fractures
Injuries like patella fractures are frequently brought on by a blow to the knee. Typical causes include
- Directly hitting the knee, particularly on a hard surface like concrete.
- Sports where a ball, bat, or stick could directly strike the knee.
- Vehicle collisions in which the knee strikes the dashboard.
- Bullet wounds.
- The quadriceps muscle suddenly contracts (pulls), causing the kneecap’s tendon to pull and tear apart.
Symptoms of Patella fractures
A patella fracture can cause the following symptoms:\
- Pain around the kneecap or in the knee.
- Swelling, which can be severe, even with relatively minor kneecap fractures.
- Inability to bend or straighten the knee or to hold the leg out straight.
- Inability to bear weight, stand or walk.
- Deformed appearance of the knee, especially with severe fractures.
- Bone protruding from the skin of the knee in the case of an open patellar fracture.
When the patella fractures or breaks, what happens?
A direct blow to your knee is usually what breaks your patella. Depending on the amount of pressure used, it could crack along a hairline, split into two pieces, or shatter into numerous tiny pieces. Your knee’s extensor mechanism may no longer work properly if you have a patella fracture. Your patella, where your quadriceps and patellar tendon attach, is what typically allows you to flex and extend your knee. Your knee joint is cushioned by the cartilage that covers the patella. With this kind of fracture, the cartilage may be damaged, which may result in post-traumatic arthritis.
Different types of Patella fracture?
Stable patella fracture
When your bone sustains a stable fracture, also known as a “nondisplaced” fracture, the broken pieces essentially stay in the same position. They might still be in contact or they might be a millimeter or two apart. Typically, this kind of fracture heals successfully without surgery. Your knee will be immobilized in extension with a knee immobilizer, a hinged knee brace, or a cast if your doctor decides you don’t need surgery. You may carry as much weight as you find comfortable.
Displaced patella fracture
When you have a displaced fracture, the broken pieces of your bone are not aligned with one another as they should be. Surgery is frequently required to replace these parts, allowing your knee to heal and resume normal function.
Transverse patella fracture
When your patella fractures in two, it is said to have a transverse fracture. Surgery is frequently used to repair these breaks. These injuries can be treated surgically using a variety of techniques. Which is best for you will be determined by your surgeon.
Comminuted patella fracture
Your bone has broken into three or more pieces if it has suffered a comminuted fracture. A fracture with multiple fragments may be stable or unstable. Some of your bone fragments may be too small to reconnect if your comminuted fracture is unstable, and you may need to have surgery to remove them.
Open patella fracture
Your skin has been broken over your bone in an open fracture. Either something has entered your knee from the outside or pieces of your bone have broken through your skin. Antibiotics and surgery are needed right away to treat an open fracture and completely close the wound. It’s critical to seek immediate medical attention for open fractures because they frequently become infected more easily. The surgical procedure that will best heal your fracture will be determined by your surgeon.
Diagnosis of Patella fracture
Your doctor will examine your knee after talking with you about your symptoms and medical background. Especially if the fracture is displaced, the fracture’s edges can frequently be felt through the skin.
Your doctor will examine you and look for hemarthrosis. Blood from the broken bone ends accumulates inside the joint space in this condition, resulting in uncomfortable swelling. Your doctor might drain a lot of blood from your knee to help with pain management.
X-rays show images of dense structures like bone. Your doctor will order x-rays from various angles to look for a fracture and to see how the bones are aligned.
Although it is uncommon, a person may be born with extra bones in the patella that did not develop together. This is known as bipartite patella and can be mistaken for a fracture. X-rays will aid in the diagnosis of bipartite patella. Because many people have the condition in both knees, your doctor may also take an x-ray of the other knee.
Treatment of Patella fracture
You may not need surgery if the bone fragments are not displaced. A cast or splint may be applied by your doctor to keep your knee straight and prevent motion in your leg. This will keep the broken bone ends in place while they heal.
Your bone fragments will need to be surgically reassembled if they are dislocated. Because of the powerful muscles attached to your knee, which have a tendency to pull the bone pieces apart, bones that are too far apart from one another have a difficult time coming back together on their own. Your bone fragments can be joined together by orthopedic surgeons using screws, pins, plates, or wires. Your surgeon might remove any bone fragments that are too small. Your tendon may also require reattachment to your bone.
Healing time of patella fracture?
Depending on the severity of your fracture and whether you underwent surgery or not, the healing process for a patella fracture can vary. Most people can resume all of their regular activities within three to six months after feeling better in about six weeks. Some people continue to wear a knee brace for support because they experience chronic pain or stiffness.
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