Fracture of patella

Fracture of the Patella

A fracture of the patella is a break in the patella, commonly known as the kneecap, a small bone located at the front of the knee joint. The patella plays a crucial role in knee mechanics, acting as a fulcrum to increase the leverage of the tendons from the quadriceps muscle group. Due to its position, the patella is vulnerable to fracture through direct impact or indirect mechanisms such as sudden contractions of the quadriceps muscle.

Causes

Fractures of the patella can occur through several mechanisms. Direct trauma, such as a fall directly onto the knee or a blow to the kneecap, is a common cause. Indirect injuries, resulting from a sudden contraction of the quadriceps muscle with the knee in a bent position, can also lead to a patellar fracture. This type of injury is often seen in athletes and can result from jumping or abrupt changes in direction.

Symptoms

Common symptoms of a patellar fracture include:

• Severe pain in the knee area
• Swelling and bruising over the kneecap
• Difficulty in straightening the knee or walking

In some cases, if the fracture is displaced, there may be a noticeable gap in the knee where the pieces of the patella have separated.

Diagnosis

Diagnosis of a patellar fracture typically involves a physical examination and imaging tests. During the examination, a healthcare provider will assess the knee's swelling, tenderness, and range of motion. X-rays are the most commonly used imaging test to confirm the presence of a fracture and assess its severity. In some cases, a CT scan or MRI may be recommended for a more detailed view.

Treatment

Treatment for a patellar fracture depends on the type and severity of the fracture. Non-displaced fractures, where the bone pieces remain aligned, can often be treated conservatively with immobilization. The knee may be placed in a cast or brace for several weeks to allow the bone to heal.

Displaced fractures, where the bone pieces have moved out of alignment, may require surgery. Surgical options include internal fixation, where hardware such as screws and wires are used to hold the bone pieces together, or partial or total patellectomy, the removal of part or all of the patella.

Recovery

Recovery from a patellar fracture varies depending on the injury's severity and the treatment method. Physical therapy is an essential part of the recovery process, helping to restore knee strength and mobility. Full recovery can take several months, and in some cases, there may be long-term effects such as knee stiffness or arthritis.

Prevention

Preventive measures for patellar fractures include wearing protective gear during sports activities, maintaining muscle strength and flexibility to support the knee, and avoiding activities that put undue stress on the knees.