Patella Fracture: Causes and Treatment

What is Patella?

Patella (also called knee-cap or kneepan), is a thick circle-triangular bone that articulates with femur and protects the anterior articular surface of our knee joint. It is the biggest sesamoid bone in our body.

What is Patella Fracture?

It is nothing but an injury to kneepan / kneecap. Kneecap is 1 of 3 bones that forms our knee joint. Structurally, patella is covered with cartilage on its under-surface and is crucial in providing extension strength of knee joint.

Causes

So, how does patella fracture happen? The fracture mostly occurs when someone falls over his/her kneecap. When such fracture happens due to this kind of direct impact, there’s often damage to skin above the knee and because of very limited skin tissues on our knee, it so easily becomes an open fracture.
In many cases, it has been observed that patella fracture may also happen when quadriceps muscle is contracts whereas knee joint is still straightening (this is also known as eccentric contraction). What happens is that – when muscle pulls forcefully because of the impact, patella can break.

Treatment

Patella is among severe fractures and it has to be seen a hospital emergency room. The most obvious way to diagnose fracture is by X-rays. Patella X-ray determines the severity (extent of displacement) of the fracture and exact fracture type.

Knee cap fracture test

The quickest (not the most painful certainly) way for doctors to diagnose this type of fracture is to ask sufferer to straighten leg by raising it. During this test, straight leg raise test is done by asking the patient to lie on a flat surface. With his/her leg straight, patient is asked to raise foot off the bed and hold it in the air. This was this test works is that it tests the functioning of quadriceps muscle and is it properly attached to tibia. Patient’s quadriceps tendon injury (or to patella or patellar tendon) can cause inability to perform straight leg raise.

When does Patella Fracture need surgery?

In the above knee test, if patient is able to straighten his/her leg raise, then non-surgical treatment can be applied to set-up patella to its original position.

Symptoms

One of the most common symptoms of patella fracture is immediate swelling of knee. This swelling occurs from bleeding around fractured bone (ends into the knee joint). Patients with too much blood (in the knee) can be treated by draining blood for immediate pain relief. Immobilizing knee with the help of a knee brace can also help relieve from discomfort.

Surgery

As mentioned before, patients with partially or completely displaced fracture (who are able to perform straight leg raise) can be treated without surgery. In such cases, a long-leg cast (or a knee immobilizer) can be applied for treating such kinds of patellar fractures.

What happens in a Patella Surgery?

When operative surgery is the only option, doctor has to make an incision on knee joint front. Doctor then realigns ends of the bone and held together with the help of pins, screws and wires. In few cases, doctor can also remove fraction of patella (in case of smaller fracture fragments).

Possible complications with Surgery:

Complications in a Patella surgery can be:

  • Pain caused by metal implants
  • Infection
  • Non-healing fractures
  • Failure of the fixation to hold the fragments in place
  • Kneecap pain (chondromalacia)
  • Knee arthritis

Patella Surgery Rehab

After corrective operative surgery, patients are asked to keep their injured knee in a straight position to allow initial healing (with un-interrupted blood supply).

How much time does it take to recover?

How quickly patella fracture heals and how quickly back again you are able to move your knee depends a lot on the skill of the surgeon – that is, strength of the repair your doctor was able to achieve during surgery. Little motion can usually begin in the second week after surgery.

The Healing

Complete healing of patella can take more than 10 weeks; however, this healing period can be decreased by using herbal supplements like Cissus.