Your physical therapist may recommend incorporating simple stretching and strengthening movements into a home routine in between sessions. Physical therapy may continue once a week for six to eight weeks or until the patella fracture is healed completely.
Nonsurgical Treatment of Patella Fractures | NYU Langone Health
- Physical Therapy. Your physical therapist may recommend incorporating simple stretching and strengthening movements into a home routine in between sessions. Physical therapy may continue once a week for six to eight weeks or until the patella fracture is healed completely.
- 1 How long does it take to recover from a fractured patella?
- 2 When do you start physical therapy after patellar fracture?
- 3 What exercises can I do with fractured patella?
- 4 How long does it take to recover from a fractured patella without surgery?
- 5 How do you sleep with a broken patella?
- 6 Can you fracture your knee and still walk on it?
- 7 Can I exercise with a broken patella?
- 8 Can you run after a fractured patella?
- 9 Should you sleep with a knee brace?
- 10 Can you drive with a fractured knee?
- 11 How do you know a fracture is healing?
- 12 Can you walk on a hairline fracture?
- 13 Recovery & Support for Patella Fractures
- 14 Medication
- 15 Physical Therapy
- 16 Smoking Cessation
- 17 What exercises should I do after fractured patella?
- 18 What exercises should I do after fractured patella?
- 19 Patellar Fractures
- 20 Definition/Description
- 21 Clinically relevant anatomy
- 22 Epidemiology/Etiology
- 23 Complications
- 24 Characteristics/Clinical Presentation
- 25 Differential diagnosis
- 26 Diagnosis
- 27 Outcome measures
- 28 Medical management
- 29 Physiotherapy management
- 30 Resources
- 31 References
- 32 Patellar Fractures (Broken Kneecap) – OrthoInfo – AAOS
- 33 Kneecap Fractures (Patella Fractures)
- 34 Types of Kneecap Fractures
- 35 What causes kneecap fractures?
- 36 Kneecap Fracture Symptoms
- 37 Kneecap Fracture Diagnosis
- 38 Treatment for a Fractured Kneecap
- 39 Recovery and Complications After a Patella Fracture
- 40 Kneecap Fracture Exercises
- 41 Broken kneecap – aftercare: MedlinePlus Medical Encyclopedia
How long does it take to recover from a fractured patella?
Depending on your age and health, it takes about three to six months to recover from a broken kneecap, but very severe patellar injuries may take longer. For a time, you may be advised to avoid climbing stairs, squatting, kneeling or other activities that place strain on the knee joint.
When do you start physical therapy after patellar fracture?
Physical therapy can begin as soon as your doctor determines that your knee can bend. This may be within days of an injury if the patella fracture does not require surgery. If surgery is performed, gentle weight-bearing exercises typically begin three to six days after surgery.
What exercises can I do with fractured patella?
Kneecap Fracture Exercises
- Standing hamstring stretch: Put the heel of the leg on your injured side on a stool about 15 inches high.
- Quadriceps stretch: Stand at an arm’s length away from the wall with your injured side farthest from the wall.
- Side-lying leg lift: Lie on your uninjured side.
How long does it take to recover from a fractured patella without surgery?
The healing process for a patella fracture can vary, depending on the severity of your break and whether you had surgery or not. Most people will be feeling good in about six weeks, and able to return to all of their normal activities within three to six months.
How do you sleep with a broken patella?
Keep your leg elevated to reduce pain and swelling. When sleeping, put a pillow under the injured leg. When sitting, support the injured leg so it’s above the level of your heart. This is very important during the first 2 days (48 hours).
Can you fracture your knee and still walk on it?
In most cases, patients can walk while the bone heals as long as the brace keeps the knee straight during ambulation. Most patients use crutches, a walker or a cane for stability during the healing process.
Can I exercise with a broken patella?
take 6 to 8 weeks for the knee to heal. You will then need to do rehabilitation exercises for several weeks.
Can you run after a fractured patella?
By six to 12 weeks, we will organize an activity plan to have you walking better and participating in other forms of exercise. Activities might include pool running and exercises in water. With regular physical therapy, you can reduce pain and continue to stay active after a patellar fracture.
Should you sleep with a knee brace?
Home care. The knee brace should be worn whenever you are out of bed, unless told otherwise. You may wear it in bed while asleep for the first few nights or until the pain starts to go away. Otherwise, you can remove the brace at night to avoid muscle stiffness from lack of joint movement.
Can you drive with a fractured knee?
You should eventually be able to resume functional activities like stair climbing, single leg support, swimming, and driving. You will be able to begin more vigorous activities as your kneecap heals and your leg gets stronger.
How do you know a fracture is healing?
Signs Your Broken Bone Is Healing
- What You Experience During Healing. The following steps are what you will go through as your broken bone is healing:
- Pain Decreases.
- Range of Motion Increases.
- Swelling Goes Down.
- Bruising Subsides.
- Orthopedic Clinic in Clinton Township, MI.
Can you walk on a hairline fracture?
Although one can walk on a foot with a stress fracture, these tiny hairline breaks should not be ignored as they can return unless properly treated.
Recovery & Support for Patella Fractures
Recovery from a fractured patella, often known as a broken kneecap, can take many months, and the doctors and experts at NYU Langone are devoted to ensuring that you stay as comfortable and mobile as possible during your treatment and recovery.
The committed team of pain management specialists at NYU Langone is here to assist you 24 hours a day, seven days a week. While you pursue nonsurgical therapy, your doctor might send you to a pain management expert to help you manage any discomfort. If you’ve undergone surgery, you’ll be seen by a pain management expert as soon as possible following the operation. When you are feeling well enough to begin physical therapy, which is an important component of your rehabilitation from a broken patella, pain medications can help you feel more comfortable.
It is possible that your doctor will prescribe a stronger medicine to be used during the first week or two following your accident if the pain is severe.
Whether you have undergone surgery or nonsurgical therapy for your damaged knee, rehabilitation is a vital aspect of your healing process. Physical therapy can assist you in regaining your strength and range of motion more rapidly. It also aids in the strengthening of the muscles surrounding your knee, minimizing the likelihood of another injury occurring in the future. The highly trained team of physicians and therapists at Rusk Rehabilitation at NYU Langone has extensive experience in helping people recover from patella fractures.
Physical therapy can begin as soon as your doctor determines that your knee is able to be bent comfortably again.
If surgery is undertaken, modest weight-bearing activities are usually started three to six weeks after the procedure.
According to research, the nicotine included in cigarettes causes bone mending after a fracture to be slower. New York University Langone doctors realize how difficult it is to quit smoking and can send you to one of our Tobacco Cessation Programs for support.
What exercises should I do after fractured patella?
What kind of workouts should I perform once I have a broken patellar tendon?
What exercises should I do after fractured patella?
Knee stiffness is the most prevalent consequence after a patella fracture, followed by pain and swelling. As a result, physical activity is essential for returning to a regular lifestyle. Patella fractures can be treated without surgery (if the fracture is not displaced) or with surgery (if the fracture is displaced) (for displaced fracture fragments).
Exercises after patella fracture treated conservatively (without surgery)
If the condition is not addressed surgically, the knee should be immobilized in a knee brace that is locked in full extension (straight knee) for four weeks. In these four weeks, you should perform straight leg raising, static quadriceps exercise, hamstring stretching and hip abduction and adduction movements, which are all listed in the following section. All of these exercises can be performed while the brace is locked in full extension. While walking, you can place weight on the injured limb to help it heal.
Take a seat and Maintain a straight back when sitting in a chair with your legs dangling over the side.
Straighten one of your legs out in front of you now. Hold it in place for 10 seconds before lowering it to the floor below. Repeat the process with the opposite leg. Do this 10 to 20 times with each leg and twice with each arm.
ACL reconstruction is a surgical operation that is performed to repair the ligament in the middle of your knee in order to restore its function after it has been damaged. Arthroscopic procedures, often known as keyhole surgeries, are performed to treat joint diseases. They allow for a shorter hospital stay and a quicker recovery. A painful injury in which the upper arm bone dislocates out of its normal position, causing significant damage to the soft tissues in the surrounding region. A common sports injury that develops over time as a result of normal wear and tear on the muscles and tendons of the body.
In the event of a rotator cuff tear, we provide the most up-to-date arthroscopic and minimally invasive single and double row rotator cuff repair techniques.
Schedule an appointment with Dr. Jitesh to get right diagnosis and cure for your ailment. Someone from our team will get in touch with you.
Rachel Lowe was the original editor. Leading contributors include: Marie Avau, Leana Louw, Lisa De Wael, Admin, Rachel Lowe, Debbie Decock, Kim Jackson, WikiSysop, Karen Wilson, Claire Knott, Manisha Shrestha, Evan Thomas, Scott Buxton, and Oyemi Sillo.
Patellafractures can be induced directly by trauma or a compressive force, or indirectly as a result of quadriceps contractions or an excessive amount of tension placed on the extensor mechanism of the knee. Indirect injuries are frequently connected with tears of the retinaculum and vastus muscles, among other things. Patella fractures account for around one percent of all bone injuries.
Clinically relevant anatomy
The patella is a triangular bone that is located on the anterior aspect of the knee near the distal end of the femur, on the inside of the knee. It is the biggest sesamoid bone in the body and forms a portion of the knee joint, as can be seen in the image below. The vastus medialis and lateralis, which are both members of the quadriceps group, are responsible for controlling movement at the patella. The extensor mechanism as a whole is important in the development of patella fractures. The quadriceps, quadriceps tendon, retinaculum, patella tendon, tibial tubercle, and patellofemoral and patellotibial ligaments are all components of the quadriceps muscle.
Following patella fractures for one year, according to a recent study, the average death rate was 2.8 percent, with the rate increasing to 6.2 percent in the senior group. Patella fractures are not connected with an elevated mortality rate, as evidenced by the fact that the relative risk of death was 0.9 in this study.
- Sprains and ruptures of the ligaments and tendons that are connected to the patellar tendon Avascular necrosis
- Post-traumatic arthritis
- And other conditions Topatellofemoral joint injury caused by osteochondral erosion
- Injuries that occur simultaneously (e.g., injuries to the acetabulum, femur, and tibia)
- Long-term ramifications include:
- Stiffness, extension weakness, and patellofemoral arthritis are all symptoms of patellofemoral arthritis.
Displaced patella fractures are distinguished from non-displaced patella fractures. Displaced fractures are unstable and can be further subdivided into the following categories:
- Comminuted: As a result of direct trauma (usually as a result of blows or falls on a flexed knee), the knee becomes comminuted.
- It is possible to cause injury to the articular cartilage of the patella and femoral condyles while using this product.
- In response to muscular contraction/extensive stress on the extensor mechanism, for example, an intense quadriceps contraction after leaping from a high altitude
- The most frequent form
- The blood flow to the area may be impaired
- Usually as a result of excessive flexion of the knee joint
- As a result of a fall on the knee, the knee is considered marginal. A vertical/longitudinal pole
- A lower pole and an upper pole Osteochondral
- Sleeve (only in patients under the age of 18)
The degree of chondral damage present at the time of the injury determines the prognosis of the condition.
Functional outcome is dependent on the ability to achieve pain-free and stable range of motion in the earliest stages of the injury.
- Bipartite patella
- Dislocation of the kneecap
- Dislocation of the patella.
- Detailed information on the accident
- The cause of the damage
- Knee discomfort
- Standing difficulties or a cracking feeling at the knee have been reported.
- The whole extreme
- Knee that is swollen and bruised
- Deformity around the knee Wounds (open fracture) are a possibility.
- Palpation (which is frequently performed after local anesthetics have been administered to alleviate pain) includes the following procedures:
- Palpation (which is frequently performed after local anesthetics have been administered to alleviate pain) includes the following techniques:
- Knee flexion and extension are restricted, and it is painful. Frequently unable to perform a straight leg raise
- Pulses at the distal end
- Determine the compartment of the leg
- Evaluation of the nervous system
- Undisplaced -2mm separation
- Displaced -2mm separation, step deformity detected
- Undisplaced -2mm separation
- Displaced -2mm separation, step deformity noted
- Horizontal perspective
- Used for frequent monitoring of the healing process and any potential issues
- CT scan: This is usually not required. MRI: Diagnosis of related injuries to the tendons and ligaments in the surrounding area. Stress fractures can be detected using bone scans.
- Injury to the knee and osteoarthritis of the knee result score
- An evaluation of the knee’s result
- Lower extrimity function scale
- McGill pain questionnaire
- Lower extrimity function scale
- To relieve pain in severe situations, local anesthetics can be administered topically. Patella fracture testing and diagnosis are made easier as a result of this
It is indicated in the case of an undisplaced fracture (most commonly vertical, horizontal, or comminuted fracture) with an intact extensor mechanism. Management:
- POP cylinder cast or range of motion brace locked in extension (4-6 weeks) for fracture immobilization:
- Knee flexion can be gradually increased as the healing process progresses. This brace must be worn until the joint has fused (on X-rays) and clinical symptoms of healing (such as the absence of tenderness on probing) have been observed.
The following symptoms are present: significant displacement with the extensor mechanism not intact. To restore extensor function, correct articular incongruities, and allow for early mobility. Management is straightforward.
- Anterior transverse/simple comminuted mid-patella fracture: Open reduction and internal fixation with a tension band wire approach, which involves utilizing pins and wires to push the parts together and a ‘figure of eight’ to press the pieces together
- Proximal/distal1/3 – simple or comminuted: excision of small piecetendon repair
- Excision of small piecetendon repair
- Interfragmentary screw attachment in the longitudinal direction (uncommon). Comminuted fracture/irreducible or irreparable fracture, or when cartilage has been too extensively destroyed to be repaired: Partially vs completely removing the patellum:
- During a full patellectomy, the quadriceps muscles are connected to the patellar ligament to ensure that the extensor apparatus continues to function properly. Patellectomy: A rather ancient technique that is often used as the final resort.
- Surgical repair of bilateral vastus muscles
- Rehabilitation will be similar to that of conservative treatment
Later stages: When athrofibrosis develops, manipulation under anesthesia or the arthroscopic release of adhesions are necessary to treat the condition.
Recognizing that clinical healing stages do not always correspond to theoretical healing phases, the surgeon will direct rehabilitation while taking X-ray data into mind. When a patient suffers a patella fracture, the following guidelines should be followed, however it is always a good idea to consult with your orthopaedic surgeons before embarking on any rehabilitation program.
When the extensor mechanism is still intact, conservative management techniques are employed.
Phase 1: 0-6 weeks
- At 2-3 weeks, the range of motion brace should be locked in extension
- The controlled motion brace should be worn at 2-3 weeks.
- Knee range of motion exercises and open kinetic chain strengthening at 3-4 weeks – concentrate on active flexionextension in inner ranges
- Gluts sets
- Open and closed kinetic chain hip strengthening exercises
- Circulatory drills
- In the brace, only a portion of the weight is supported. It is possible to stand in tandem
- Weight-bearing limitations are often enforced for 6-8 weeks after surgery. Depending on the surgeon’s recommendation, crutches or weight-bearing limitations may be required for an extended period of time.
- Mobilization of the patella
- Cryotherapy for the treatment of painoedema
Phase II: 6-12 weeks
- According to the surgeon, a range of motion knee brace should be used.
- Bike that is stationary with the seat elevated and no resistance. Exercises that progress the closed kinetic chain include mini squats, step ups, retro steps, and other variations. Increase the resistance on hip exercises as time goes on. Proprioception
- Lunges starting in weeks 8-10
The use of surgical surgery is required in instances when there is substantial displacement and the extensor mechanism is not functioning properly. The tension band wire procedure, which involves open reduction and internal fixation, is usually the preferred method of therapy.
Phase I:0-2 weeks
- If the POP cast is not utilized, the extension is locked in. For the time being, only physiotherapy treatments will be allowed to be missed
- Initially, a 0-30° range of motion in the knee is permitted.
- With a range of motion brace, the knee is locked in extension.
- Stronger quadriceps, hamstrings, adductors, and abductors with isometric workouts
- Ankle exercises with resistance (e.g., using theraband)
Phase II: 2-6 weeks
- Designed to be worn while performing weight-bearing activities and kept in extension
- It is possible to remove it at night.
- Each week, 5 degrees of flexion can be increased, bringing the total to 90 degrees by week 6.
- Stronger quadriceps, hamstrings, adductors, and abductors with isometric workouts
- Ankle exercises with resistance (e.g., using theraband)
- Start the SLR process.
Phase III: 6-10 weeks
- To be worn for weight-bearing activities after being unlocked.
Phase IV: 10-12 weeks
- Discontinue use of the range of motion brace. Full range of motion is available. Exercises are the same as in the preceding phase.
Phase V: Up to 3-6 months
Return to usual activities as soon as tolerated by the patient.
- Patella fractures and the goods that should be used to treat them
- Non-operative therapy of patella fractures Rehabilitation recommendations for patellar ORIF
- ORIF patella fracture post-operative rehabilitation protocol
- ORIF Patella Fracture Rehabilitation Program
- ORIF Patella Fracture Rehabilitation Guidelines
- Framboll R, Cooper R, Morris H, and Arendt H. Acute knee injuries: a systematic review and meta-analysis. Among those who have contributed to Clinical Sports Medicine: 4th edition are Brukner P. Bahr R. Blair S. Cook J Crossley K McConnell J McConnell J McConnell P Noakes T Khan K McGraw-Hill Education, Sydney. p.626-683
- A review of current treatment options for patella fractures was published in Orthopedics by Schuett D.J., Hake ME, Mauffrey C., Hammerberg EM, Stahel PF, Hak DJ. 2015
- The authors, Michael T. Archdeacon and Roy W. Sanders, wrote 3.03.1 Archdeacon and Roy W. Sanders: Patella Fractures and Extensor Mechanism Injuries are covered in detail in Chapter 54. The following are the editors’ notes: Browner BD, Jupiter JB, Krettek C, Anderson PA. Skeletal Trauma, 4th edition, is a textbook on skeletal trauma. Elsevier Health Sciences published a book in 2008 titled In 2005, the British Journal of Sports Medicine published a study on the propagation of a stress fracture in the patella (Crowther MA, Mandal A, Sarangi PP). Patellectomy was first described in 1964 in Postgraduate Medical Journal, volume 40, number 467, page 531. ↑Cedars-Sinai. Kneecap has been fractured. Cedars Sinai is a non-profit organization. 25/07/2018)
- M. Schukne, et al. Prometheus, the anatomical atlas, is a mathematical formula.
Patellar Fractures (Broken Kneecap) – OrthoInfo – AAOS
Unstable patellar fractures are caused by a break in the patella, also known as the kneecap, which is the tiny bone that lies at the front of the knee joint. Because the patella serves as a protective barrier for your knee joint, it is particularly prone to fracture if you fall straight onto your knee or if your knee is struck against the dashboard of a moving vehicle. When your patellar fracture occurs, it might be difficult or even impossible to straighten your knee and walk. Some small patellar fractures can be treated by immobilizing the knee in a cast or splint until the bone heals completely.
Surgery is required for these more complex fractures in order to repair and stabilize the kneecap and let the patient to walk again.
Types of Patellar Fractures
Fracture that is stable. Nondisplaced fractures are the most common form. The fragments of bone may remain in touch with one another or they may be separated by only a millimeter or two from one another. During the healing process of a stable fracture, the bones are normally held in place. Fracture that has been displaced. During a displaced fracture, the shattered ends of the bone are separated and do not line up appropriately with the surrounding bone. It is also possible that the typically smooth joint surface will be disturbed.
Fracture with comminuted fragments.
A comminuted fracture can be classified as either stable or unstable, depending on the precise pattern of the fracture that has occurred. There is an open fracture. An open fracture occurs when the bone breaks in such a way that bone pieces are exposed.
- Coming down on your knee
- Falling squarely upon your knee
- When you get a powerful hit to the knee, such as when your kneecap is slammed into the dashboard of a moving vehicle in a head-on accident, you should seek medical attention immediately.
Indirect fractures of the patella are also possible. In the knee, for example, a rapid contraction of the quadriceps muscle can cause the patella to be separated from the femur. In the case of a patellar fracture, the most typical symptoms are pain and swelling in the area in front of the knee. Other signs and symptoms to look out for are:
- There is bruising, and you are unable to straighten your knee or maintain it extended in a straight leg raise. being unable to walk
After talking with you about your symptoms and medical history, your doctor will do an examination of your knee. The edges of a fracture can frequently be felt through the skin, especially if the fracture is displaced from its original location. During the examination, your doctor will look for signs of hemorrhoids. During this disease, blood from the shattered bone ends gathers inside the joint area, resulting in severe swelling and inflammation. If you have a significant amount of blood in your knee, your doctor may recommend that you have it drained to help relieve your pain.
X-rays are used to create images of dense structures, such as bone, in the body. Your doctor will order x-rays from a variety of various angles in order to check for fractures and to see how the bones are aligned with one another. Although it is uncommon, a person may be born with additional bones in the patella that have not fused together during development. Bipartite patella is the medical term for this disorder, which might be mistaken for a fracture. The use of X-rays will aid in the identification of bipartite patella.
If the bits of bone are not out of position (displaced), you may be able to avoid having to undergo surgical intervention. Your doctor may recommend that you wear a cast or splint to maintain your knee straight and to assist prevent mobility in your leg after you have had surgery. While the shattered ends of bone mend, this will help to retain them in the appropriate place. In certain cases, you may be able to bear weight on your leg while wearing a cast or brace, depending on the nature of the fracture.
The limits on weight bearing will be discussed with you by your physician.
The majority of the time, if the bone pieces are out of place (displaced), surgery will be required. Those who have fractured patellar bones that are not close together frequently experience problems healing or may not heal at all. The thigh muscles that link to the top of the patella are quite powerful, and they have the potential to pull the shattered parts out of their proper positions throughout the healing process. Surgery should be performed at a certain time. Your doctor may recommend that you wait until any abrasions on the skin around your fracture have healed before having surgery if the skin around your fracture has not been broken.
A thorough cleaning is performed during surgery to remove all debris and blood from the wounds caused by the injury and the bone surfaces. Typically, the bone will be mended throughout the procedure.
The sort of operation that is done on you is frequently determined by the type of fracture you have. If you have a question about your operation or any possible consequences, your doctor will address them with you prior to the surgery. Fracture in the transverse direction. These two-part fractures are most typically held in place by screws or pins and wires, as well as a tension band in a “figure-of-eight” arrangement. The figure-of-eight band holds the two pieces of jewelry together tightly.
The fracture fragments at the extremities of the kneecap are too tiny to be repaired with this technique.
When treating a transverse fracture, another option is to use small screws or small screws and small plates to hold the bones together.
Some fractures have the appearance of a crack.
The majority of fractures cause mild discomfort for a few days to a couple of weeks. When it comes to pain treatment, many people discover that applying ice to the afflicted leg, elevating the leg, and using basic, non-prescription drugs are all that is required. To relieve severe pain, your doctor may prescribe a prescription-strength medicine for a few days, such as an opioid, to be taken by mouth. You should be aware that, despite the fact that opioids can help to relieve pain after surgery, opioid dependency and overdose have become a serious public health concern.
When using opioids, it is critical to follow the directions of your doctor.
Regardless of whether you have surgery or nonsurgical therapy, rehabilitation will be critical in helping you return to your normal activities. It is possible that your knee will become stiff and your thigh muscles will become weak as a result of your leg being immobilized in a cast for an extended period of time during treatment for a patellar fracture. During your rehabilitation, your doctor or a physical therapist will give you specific exercises to help with the following things:
- Increase the range of motion in your knee
- Strengthen the muscles in your legs
- And reduce stiffness.
Once your doctor has determined the appropriate time for you to begin bearing weight on your leg, follow his or her instructions. Weight-bearing activity is normally confined to lightly putting your toe to the floor during the first several weeks of recovery. Gradually increasing the amount of weight you can bear on your injured leg will occur as your injury heals and your muscles develop. It is possible that some individuals with patellar fractures will face long-term problems even after receiving effective treatment.
The term “posttraumatic arthritis” refers to arthritis that develops following an injury of some kind. In spite of the fact that your bones mend regularly, the articular cartilage that covers your bones might be injured, resulting in discomfort and stiffness over time.
Patients with patellar fractures are more likely than the general population to develop severe arthritis. Mild to moderate arthritis (also known as chondromalacia patella) is far more frequent than severe arthritis.
It is possible that some patients will have persistent weakening of the quadriceps muscle in the front of the leg as a result of their fracture. It is also normal to have some loss of knee mobility, which can include both straightening (extension) and bending (flexion). Normally, this loss of motion is not considered to be disabling.
Patellar fractures are frequently associated with long-term discomfort in the front of the knee. While the exact source of this discomfort is not known, it is likely to be connected to posttraumatic arthritis, stiffness, and muscular weakness, all of which are common symptoms. Some patients report that wearing a knee brace or support makes them feel more comfortable in their own skin. The length of time it takes to heal from a patellar fracture will be determined by a variety of factors, including the following:
- What caused your injury
- The extent of your damage. Regardless of whether you had surgery or nonsurgical therapy
- The amount of time required for recuperation
The majority of patients will be able to return to their usual activities within 3 to 6 months of their initial surgery. Patients who have suffered serious fractures may require more time to resume their normal activities. Your doctor may advise you to make certain modifications to your lifestyle in order to better protect your knee and avoid future issues. Some examples of this may include avoiding tasks that require repetitive deep knee bending or squatting. Climbing stairwells or ladders should also be avoided if at all possible.
Kneecap Fractures (Patella Fractures)
A kneecap (patella) fracture is a break in the bone that surrounds the knee joint on the outside of the knee. When you look at it closely, the patella is an asesamoidbone, which means it is a spherical bone encased in a tendon that shelters and protects a joint. In the case of the patella, ligaments connect it to both the thigh muscles (quadriceps) and the shinbone, which helps to prevent it from slipping (tibia). Because of the initial blow to the knee, kneecap fractures might be followed by injuries to the tendons and ligaments of the knee.
Types of Kneecap Fractures
The type of patella fracture that occurs is determined by the mechanism of injury and the severity of the injury. It can be influenced by your body weight and general well-being, for example.
Displaced and Nondisplaced Kneecap Fractures
- It is possible to have a nondisplaced kneecap fracture if the patella is shattered but has not shifted out of its original position. The patella is broken, and the pieces of bone have moved out of their original positions in displaced patella fractures.
Closed and Open Kneecap Fractures
- When the fractured parts of patella do not penetrate the skin, a kneecap fracture is called closed. When a kneecap fracture is open, the bones protrude through the skin, resulting in a complicated wound.
Comminuted, Noncomminuted and Hairline Kneecap Fractures
- It is possible to have three or more fragments of bone broken off the patella during a comminuted patella fracture. It is possible to have a noncomminuted patella fracture, which means that the kneecap is broken in two pieces. A hairline kneecap fracture is a little fissure in the bone that occurs at the kneecap (the patella is still in one piece). Hairline fractures, also known as stress fractures, are extremely rare in the kneecap and occur mostly in the tibia. They can occur in athletes, such as marathon runners, and are thought to be caused by overuse of the muscles. An X-ray of the patella may be difficult to detect if there is a stress fracture present. Inflammation of the anterior cruciate ligament causes discomfort in the front of the knee that worsens with time.
Patellar Sleeve Fractures
Children can suffer from patellar sleeve injuries, which most typically occur between the ages of 8 and 12, when the bony part of the knee is still growing. The injury occurs when the bony component of the patella is dragged out of its cartilage sleeve, causing it to sprain. Because the bone is not shattered, this is not technically a fracture, despite the fact that it is treated in a similar manner.
What causes kneecap fractures?
Patella fractures are common knee injuries that are caused by a direct impact to the knee. The following are examples of common causes:
- The impact of a fall on the knee, particularly on a hard surface such as concrete
- A ball, bat, or stick may strike the knee directly
- Sports in which the knee may be directly struck by a ball, bat, or stick
- Accidents in which the knee collides with the dashboard
- Wounds from a gunshot
- Spontaneous contractions (pulling) of the quadriceps muscle that cause the tendon to pull on the kneecap and cause it to break apart.
Kneecap Fracture Symptoms
The following are some of the signs and symptoms of a patella fracture:
- Kneecap pain or knee pain
- Pain around or in the knee
- Swelling, which can be severe even in the case of a very slight kneecap fracture
- And numbness and tingling. Impossibility of bending or straightening the knee, or of keeping the leg out straight
- Inability to support one’s own weight, stand, or walk
- The appearance of the knee is deformed, especially when there is a severe fracture. In the event of an open patellar fracture, the bone will protrude from the skin of the knee and be visible.
Immediately contact your doctor or go to an urgent care facility if you have any of these symptoms after striking or damaging your knee or leg.
Kneecap Fracture Diagnosis
Your doctor may use one or more of the techniques listed below to determine whether or not you have fractured your patella:
- Sports injuries, traffic accidents, and falls are all examples of recent trauma that the doctor will inquire about. Examine the knee and check for deformity that can be felt through the skin, such as gaps or edges of bone
- The doctor will also look for signs of arthritis. The doctor may apply light pressure to the kneecap and bend or straighten the leg to see whether these activities cause or worsen discomfort, or whether they indicate a deformity. X-rays assist the doctor in identifying a fracture and determining whether or not there are fragments.
Treatment for a Fractured Kneecap
Treatment for a patella fracture varies based on the severity of the break, as well as your age, health, and other characteristics, such as your gender and ethnicity.
Patella fractures have the potential to induce significant bleeding into the joint. Emergency therapy may include the removal of blood and fluid from the joint in order to lessen swelling and discomfort and to make it simpler to detect the condition in the future.
Treatment that does not involve surgery is often suggested for less severe patellar fractures or less stable patellar fractures, and may involve the following:
- While the bone is healing, the leg is cast or splinted to keep it in place. Preventing or lowering the amount of weight that is supported In the case of a severe kneecap fracture, opioid pain medication may be appropriate for the first few days after the injury, followed by non-opioid options
- Physical therapy and walking aids are available to assist you in regaining your strength and independence.
Kneecap Repair Surgery
In the case of more severe kneecap fractures, surgical intervention is usually recommended. Surgical repairs may include the following:
- Holding together bigger sections of patella with screws, pins, and wires is a good idea. Remove bone fragments that are too tiny to be reattached after they have been removed. It may be essential to remove part or all of the kneecap in really severe comminuted fractures, although the surgeon will make every effort to save and restore as much of the kneecap as feasible. Deal with any damage to the patellar ligament and other structures in the knee joint that has resulted from the fracture (for example, in the event of an open fracture where bone fragments have penetrated the skin and soft tissue).
Recovery and Complications After a Patella Fracture
The knee is a complicated joint that has to withstand a lot of weight. Even after receiving therapy, you may continue to feel discomfort and a limited range of motion. Knee post-traumatic arthritis (thinning of cartilage as a result of a traumatic injury) is an extremely prevalent consequence of patella fractures and other types of knee injuries. Atrophic muscle loss (muscle atrophy) in the leg may occur after several weeks or months of immobility with a cast or splint. Rehabilitation can assist in minimizing atrophy and keeping it from becoming permanent, as well as restoring muscular strength, flexibility, and range of motion in the affected muscle(s).
It takes between three to six months to recover from a damaged kneecap, depending on your age and health.
Kneecap Fracture Exercises
Exercises to aid in your recovery may be recommended by your healthcare practitioner. Consult with your healthcare provider or physical therapist to determine which exercises will be most beneficial to you and how to perform them correctly and safely. You can begin stretching your hamstrings right away. As soon as your knee pain subsides, you can perform the quadriceps stretch and begin strengthening the thigh muscles with the rest of the exercises.
- The heel of your affected leg should be propped up on a 15-inch high stool as you perform a standing hamstring stretch. Maintain the straightness of your leg. Allow yourself to lean forward and bend at the hips until you feel a moderate stretch in the back of your leg. You must avoid rolling your shoulders or bending at the waist when performing this exercise otherwise you will wind up stretching your lower back rather than your leg. Stretch for 15 to 30 seconds, depending on how tight the stretch is. Repeat the process three times. Stretch your quadriceps by standing at an arm’s length away from a wall, with your injured side facing the wall and your other side facing the wall. Maintaining one hand against the wall while looking straight ahead will help you to stay stable. Take hold of the ankle on your affected side with your other hand and move your heel toward your damaged side
- As you face the door on your injured leg (the leg that does not have tubing), bend your knee slightly while maintaining your thigh muscles as taut as possible. Maintain this posture as you straighten the leg with the tubing (the undamaged leg) and place it behind you straight away. Do two sets of 15 reps each
- Rotate your body 90 degrees so that the leg without the tubing is closest to the door. Reposition the leg that has the tubing away from your body. Do two sets of 15 reps each
- Then turn 90 degrees so that your back is facing the door. Straighten the leg with the tube so that it is directly in front of you. Do two sets of 15 reps. Then turn your body 90 degrees again so that the leg with the tubing is closest to the front door. Cross your body with the leg that has the tube. Do
- If you need assistance balancing, hold on to a chair. Making this workout more difficult by standing on a hard pillow or foam pad while moving the leg with tubing might make it more difficult. Terminal knee extension with resisted resistance: Knot the ends of an elastic tubing together to form a loop, then cut the tubing. Closing a knot in a door at knee level is an excellent technique. Take a few steps into the loop with your injured leg so that the tubing is wrapped around the back of your knee. Lift the opposite foot off the ground and, if necessary, grasp on to a chair for support and balance. With the tube, bend the knee approximately 45 degrees. Slowly straighten your leg, being sure to maintain your thigh muscle firm during the process. 15 times is a good number. Do two sets of 15 repetitions. If
- Place your wounded leg in front of you and take a seat. Your leg should be absolutely straight and relaxed during the exercise. Move your kneecap sideways toward the outside of your leg with your hands, using your fingers. Then slide it to the inner of your leg by squeezing it sideways. Use your hands to gently move your kneecap toward you and then away from you for 15 to 30 seconds in each direction.
- Comparing the movement of your damaged kneecap to the movement of your intact kneecap will help you determine the cause of your injury. It is your objective to have the same amount of mobility in both kneecaps as the other. If this workout gives you discomfort, you should not perform it.
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Broken kneecap – aftercare: MedlinePlus Medical Encyclopedia
Breaking the patella, a little circular bone that lies above the front of your knee joint, results in a fractured kneecap.
When a shattered kneecap occurs, it is possible for the patellar or quadriceps tendon to be torn as well. Located in the front of your thigh, the patella and quadriceps tendon connects the large muscle at the front of your thigh to the knee joint. If you do not require surgery, you should:
- If you have a relatively slight fracture, you may simply need to restrict your activities rather than completely cease it. More than likely, your knee will be immobilized in a cast or removable brace for 4 to 6 weeks, during which time you will be required to restrict your activities.
Any skin wounds that may have developed as a result of your knee injury will be treated by your health care provider. It is possible that you will require surgery to repair or replace your kneecap if you have a serious fracture or a torn tendon in your knee. At least four times a day, lift your knee to your chest. This will assist in the reduction of edema and muscular atrophy. Ice your knee for a few minutes. Wrapping an ice pack is as simple as putting ice cubes in a plastic bag and sealing the bag with a towel.
- The ice pack should be applied every hour for 10 to 15 minutes during the first day following the accident. After the first day, apply ice to the affected area every 3 to 4 hours for 2 or 3 days, or until the pain has subsided
Pain relievers such as acetaminophen, ibuprofen (Advil, Motrin, and others), or naproxen (Aleve, Naprosyn, and others) may be used to alleviate the discomfort and swelling associated with the condition.
- Make sure to only use these products as directed. Before taking any medications, carefully read the warnings on the label. If you have heart disease, high blood pressure, renal illness, liver disease, or if you have had stomach ulcers or internal bleeding in the past, see your healthcare professional before taking these medications.
If you have a detachable splint, you will be required to wear it at all times, with the exception of when your physician instructs you otherwise.
- Your healthcare professional may instruct you to avoid putting any weight on your damaged leg for up to one week or perhaps longer. Please consult with your healthcare professional to determine how long you should avoid putting any weight on your damaged leg. After that, you can begin putting weight on your leg as long as it is not uncomfortable and your healthcare physician has given you the go-ahead. You’ll need to put the splint on your knee to protect it. You may also require the assistance of crutches or a cane to maintain your balance. When you are wearing your splint or brace, you can begin doing straight-leg lifts and ankle range-of-motion exercises
- However, you should avoid doing so for a while.
Following the removal or loosening of your splint or brace, you will perform the following:
- Exercises to increase the range of motion in your knee
- Exercises to strengthen the muscles around your knee
You might be able to return to work if you do the following:
- If your employment requires a lot of sitting, you should wait a week following your accident. If your employment requires you to squat or climb, you should wait at least 12 weeks after your splint or cast is removed.
After your healthcare physician has given the all-clear, you can resume your sporting activities. This typically takes between two and six months.
- Begin by walking or swimming in a freestyle fashion. Last, but not least, are sports that demand leaping or making sharp cuts. Do not participate in any sport or activity that will exacerbate your discomfort.
If you have a bandage on your knee, make sure to keep it clean. If it becomes unclean, it should be replaced. When your healthcare practitioner says you may, wash your wound with soap and water to keep it clean. In the event that you have stitches (sutures), they will be removed in approximately 2 weeks. It is not recommended that you take baths, swim, or soak your knee in any way until your provider gives you the green light. During your recuperation, you will need to see your healthcare physician every 2 to 3 weeks.
If you have any of the following symptoms, contact your health-care provider:
- Swelling that has risen
- Severe or increasing discomfort
- Changes in the color of your skin around your knee or below it
- Symptoms of a wound infection, such as redness, swelling, foul-smelling discharge, or a fever
Eiff MP, Hatch RL, and Higgins MK are among those who have contributed to this work. Fractures of the patellar, tibial, and fibular bones. In: Eiff MP, Hatch RL, and Higgins MK (eds. ), et al. Management of Fractures in Primary Care and Emergency Medicine Chap. 12 of the 4th edition, published by Elsevier in Philadelphia, Pennsylvania. A company called Paluska SA. Braces for the knees. In: Fowler GC, ed.Pfenninger and Fowler’s Procedures for Primary Care (Pfenninger and Fowler’s Procedures for Primary Care).
In addition, David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M.