Patella Fracture

The most common cause of fracture is a direct blow to the patella such as a fall or a motor vehicle accident. The patella can also be fractured indirectly, due to a sudden contraction of the thigh muscles.

Causes

The most common cause of fracture is a direct blow to the knee cap such as a fall or a motor vehicle accident. The patella can also be fractured indirectly, due to a sudden contraction of the thigh muscles.

Symptoms

Pain and swelling are the predominant symptoms of a patella fracture.  A few patients may also experience inability to walk and difficulty in straightening the knee. Sometimes bruising may also be seen around the fracture site.

Diagnosis

The diagnosis of a patella fracture is made by taking a focused history, physical examination, and X-ray to determine the location and pattern of the fracture.  X-ray is the most common diagnostic tool used to identify fractures.  CT scan may be recommended to further evaluate the fracture pattern and guide treatment.

Treatment

The treatment of patellar fracture depends upon the severity and nature of the fracture.

Non-surgical treatment

Non-surgical treatment can be used when the patella has not been fragmented or displaced.  Casts or splints may be used to straighten the knee and help in the healing process.  Immobilization of the affected limb for 6 to 8 weeks may also be recommended.

Surgical treatment

Surgical treatment is needed if there is displacement of fractured fragments of the bone or the distance between the fractured parts is too far and would fail to heal. Immediate surgery is recommended in case of open fracture where the fractured site is exposed through the skin. The type of procedure to be conducted depends on the nature of the fracture. Transverse fractures are fixed with the help of wires and pins and a "figure-of-eight" configuration tension band while in a comminuted fracture, the small bone fragments are removed from the knee joint.

Rehabilitation

Rehabilitation is important to help patients resume their daily activities, after healing of the fracture.  Treatment of the fracture may cause stiffness of the joint and weakness of the surrounding muscles. Physical therapy including joint mobilization, muscle strengthening, and weight bearing exercise is helpful in regaining strength and function.