Patella Fractures

What is a patella (kneecap) fracture? 

Some patella fractures can cause just a tiny crack in the bone, while others may be serious enough to shatter the bone. 

This kind of injury generally results from a fall or blow to the knee. 

Kneecap fractures may be described as:

– Open – (cuts to the skin) with open fractures there is a greater risk of infection, so urgent treatment is required 
– Transverse – straight horizontal across the tibia shaft 
– Oblique – an angled line across the shaft  
– Spiral – Like the stripes on a candy cane, often caused by a twisting motion  
– Comminuted – where the bone breaks in three or more places 
– Intra-articular – crosses the joint surface, may also involve cartilage damage and more complicated to treat and may result in arthritis.

What are the signs of a patella fracture? 

– Pain when your kneecap is touched or when you move your leg in both directions 
– You have swelling and bruising around your kneecap
– Difficulty straightening leg or doing a leg raise 
– You cannot kneel or squat 
– Most kneecap fractures are caused by a direct blow to the front of the knee or as a results of sporting trauma, worker injury or a car accident 
– The kneecap can splinter into just a few or many pieces, and often attached ligaments or tendons can be affected as a result.

How is a patella fracture diagnosed?

– A clinical examination may include a straight leg raise or your leg or extending your knee. 
– Dr Herald will see if there are concurrent injuries. 
– X-Rays are the best way to determine a fractured knee cap. CT scans may be performed to give a more accurate picture. 

What is the treatment for a patella fracture?

– Treatment may require open reduction-internal fixation surgery where Dr Herald puts the broken bones back together with pins, wires and screws – or removes pieces too damaged to repair.
– Alternatively, the patella can be removed in a procedure known as a full or partial patellectomy (either part or all the kneecap).
– After this surgery, the knee can still be extended but the extension strength will be weaker.
– A knee splint and crutches may be needed for the fracture initially along with ice packs and compression bandages.