A patella fracture is an injury that involves a crack or a break (fracture) of the kneecap. In most circumstances, this occurs during a fall onto the kneecap, or as a result of direct trauma. In some cases, the trauma can be severe enough to create damage to the skin and the fracture can become exposed. When the break is exposed in this manner, it is known as an open fracture and is a serious emergency. However, many patellar fractures are only found through an X-ray or MRI.
Symptoms and Diagnosis
Patella fractures will include the following symptoms: Bruising, pain, inability to walk, and difficulty straighten the knee. During a physical examination, your physician will maneuver and feel the kneecap to see if any physical signs lead to evidence of a fracture. An X-ray is ordered to identify the exact location of the fracture. Occasionally, an MRI is required to diagnose a more subtle fracture such as a stress fracture.
Treatment is determined by the severity of the fracture. For open fractures, and fractures that involve multiple breaks within the bone, or for a displaced patella fracture (loss of position), surgery is usually required to restore alignment. For fractures that are not displaced, surgery may not be required. In such cases, your physician may place patients in a cast or brace so that the leg remains straight in order for the patella to properly heal.
Surgical treatment for serious cases will involve careful planning. Following surgery, patients must keep their leg immobile and straight for a period of time before they can begin rehabilitation. Bending the leg is allowed in a gradual and progressive manner. Stabilizing the fracture is critical. Most fractures are fixed using pins and wires, in the configuration of a “tension band” to hold the pieces together.
Following patella fracture surgery, recovery will take place in stages and physical therapy is prescribed by your physician to ensure that proper progress occurs. Your physician will prescribe a thorough rehabilitation program that will include gradual mobility, range of motion exercises, and strengthening. It is important not to rush recovery. Typically, 3-4 months is required before returning to normal activities.