(Broken Kneecap; Fracture, Patella; Kneecap Fracture; Patellar Fracture)
Definition
Definition
A patella fracture occurs when there is a break in the patella, better known as the kneecap. The patella is a large, movable bone at the front of the knee.
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Causes
Causes
Some common causes of this injury include:
- Sharp blow to the knee
- Excessive stress on the knee
Risk Factors
Risk Factors
Factors that may increase your risk of a patella fracture include:
- Increased age
- Postmenopause
- Decreased muscle mass
- Decreased bone mass— osteoporosis
- Participation in contact sports such as football and soccer
- Obesity, which places strain on muscles, bones, tendons, and ligaments
- Violence, such as car or car-pedestrian accidents
Symptoms
Symptoms
Patella fracture may cause:
- Sudden, excruciating pain in the kneecap
- Swelling, bruising, and tenderness
- Inability to extend the knee
- Difficulty walking
Diagnosis
Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will be done. The doctor will look closely at the knee to see if there are signs of fracture. A straight leg test may be done.
Images can evaluate your knee and surrounding structures. These may include:
Treatment
Treatment
Talk with your doctor about the best treatment plan for you. Treatment options include the following:
Nonsurgical Approach
After the tests, your doctor will determine whether you need surgery. If the patella is not badly injured, your doctor will place the knee in a cast. This cast may need to be worn for 6 weeks. After that, you will wear a knee brace and do physical therapy. You may need to use a cane or crutches.
Your doctor may recommend medication to reduce swelling and pain.
Surgery
If the patella is in pieces, then you will need surgery. There are two kinds of surgery that are commonly used to treat this injury:
- Open reduction-internal fixation surgery —The doctor uses pins and screws to put the broken pieces back together.
- Patellectomy—Rarely, the doctor removes part of the kneecap or the entire kneecap.
After surgery, you will need to do physical therapy. This can involve range-of-motion exercises and stretching. You will slowly build strength in the injured leg. In some cases, another surgery will be needed to remove the pins and screws.
Depending on the injury, recovery can take weeks to several months.
Prevention
Prevention
To help reduce your chance of a patella fracture:
- Do not put yourself at risk for trauma to the bone.
- Do weight-bearing exercises to build strong bones.
- Build strong muscles to support the knee, prevent falls, and to stay active and agile.
- Wear proper padding and safety equipment when participating in sports or activities.
RESOURCES:
Ortho Info—American Academy of Orthopaedic Surgeons http://orthoinfo.org
CANADIAN RESOURCES
Canadian Orthopaedic Foundation http://www.canorth.org
References:
Patellar (kneecap) fractures. Ortho Info—American Academy of Orthopaedics website. Available at:
http://orthoinfo.aaos.org/topic.cfm?topic=A00523
Updated March 2010. Accessed August 25, 2014.
Stress fractures. The American College of Foot & Ankle Orthopedics & Medicine website. Available at:
http://www.acfaom.org/information-for-patients/common-conditions/stress-fractures
Accessed August 25, 2014.
Tay G, Warrier S, et al. Indirect patella fractures following ACL reconstruction. Acta Orthopaedica. 2006;77:494-500.
Last Updated: 9/30/2013