|Other names||Broken kneecap|
|A fracture of the patella seen on a lateral view|
|Symptoms||Pain, swelling, bruising to front of the knee|
|Complications||Injury to the tibia, femur, or knee ligaments|
|Types||Stable, displaced, comminuted, open|
|Causes||Trauma to the front of the knee|
|Diagnostic method||Based on symptom, confirmed with X-rays.|
|Differential diagnosis||Bipartite patella|
|Treatment||Casting, splinting, surgery|
|Prognosis||Generally good with treatment|
|Frequency||~ 1% of fractures|
A patella fracture is a break of the kneecap. Symptoms include pain, swelling, and bruising to the front of the knee. A person may also be unable to walk. Complications may include injury to the tibia, femur, or knee ligaments.
It typically results from a hard blow to the front of the knee or falling on the knee. Occasionally it may occur from a strong contraction of the thigh muscles. Diagnosis is based on symptoms and confirmed with X-rays. In children an MRI may be required.
Treatment may be with or without surgery, depending on the type of fracture. Undisplaced fracture can usually be treated by casting. Even some displaced fractures can be treated with casting as long as a person can straighten their leg without help. Typically the leg is immobilized in a straight position for the first three weeks and then increasing degrees of bending are allowed. Other types of fractures generally require surgery.
Patella fractures make up about 1% of all broken bones. Males are affected more often than females. Those of middle age are most often affected. Outcomes with treatment are generally good.
Sign and symptoms
The presentation for patella fracture is as follows:
- Difficult knee flexion
- Knee ROM decrease
The cause of a patellar fracture is as follows:
Treatment may be with or without surgery, depending on the type of fracture.
Undisplaced fracture can usually be treated by casting. Even some displaced fractures can be treated with casting as long as a person can straighten their leg without help. Typically the leg is immobilized in a straight position for the first three weeks and then increasing degrees of bending are allowed.
Patellectomy (in cases of comminuted fracture) is removal of the entire patella, whereas a partial patellectomy is removal of only a portion of the patella. The fracture may require tension band wiring (in case of two part fracture) to unite the fractured bones. :1765
- "Patellar (Kneecap) Fractures". OrthoInfo - AAOS. January 2017. Archived from the original on 16 October 2017. Retrieved 16 October 2017.
- Kakazu, R; Archdeacon, MT (January 2016). "Surgical Management of Patellar Fractures". The Orthopedic Clinics of North America. 47 (1): 77–83. doi:10.1016/j.ocl.2015.08.010. PMID 26614923.
- Abbasi, David. "Patella Fracture - Trauma". Orthobullets.com. Archived from the original on 17 October 2017. Retrieved 16 October 2017.
- Melvin, JS; Mehta, S (April 2011). "Patellar fractures in adults". The Journal of the American Academy of Orthopaedic Surgeons. 19 (4): 198–207. doi:10.5435/00124635-201104000-00004. PMID 21464213.
- Sueki, Derrick; Brechter, Jacklyn (2009). Orthopedic Rehabilitation Clinical Advisor - E-Book. Elsevier Health Sciences. p. 592. ISBN 978-0-323-07252-6. Retrieved 14 January 2021.
- Scuderi, Giles R. Techniques in Revision Hip and Knee Arthroplasty E-Book: Expert Consult. Elsevier Health Sciences. p. 240. ISBN 978-1-4557-3732-1. Retrieved 14 January 2021.
- Gunal, I; Karatosun, Vasfi (August 2001). "Patellectomy: An Overview With Reconstructive Procedures". Clinical Orthopaedics and Related Research. 389: 74–78. doi:10.1097/00003086-200108000-00012. PMID 11501826. Retrieved 14 January 2021.
- Foy, Michael A.; Fagg, Phillip S. (2011). Medicolegal Reporting in Orthopaedic Trauma E-Book. Elsevier Health Sciences. p. 280. ISBN 978-0-7020-4886-9.
- Rockwood, Charles A.; Bucholz, Robert W.; Court-Brown, Charles M.; Heckman, James D.; Tornetta, Paul (2010). Rockwood and Green's Fractures in Adults. Lippincott Williams & Wilkins. p. 1767. ISBN 978-1-60547-677-3. Retrieved 15 January 2021.