Patella fracture

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Patella fracture
Other namesBroken kneecap
Fracpetella.PNG
A fracture of the patella seen on a lateral view
SpecialtyOrthopedics
SymptomsPain, swelling, bruising to front of the knee[1]
ComplicationsInjury to the tibia, femur, or knee ligaments[2]
TypesStable, displaced, comminuted, open[1]
CausesTrauma to the front of the knee[1]
Diagnostic methodBased on symptom, confirmed with X-rays.[3]
Differential diagnosisBipartite patella[3]
TreatmentCasting, splinting, surgery[2]
PrognosisGenerally good with treatment[2]
Frequency~ 1% of fractures[3]

A patella fracture is a break of the kneecap.[1] Symptoms include pain, swelling, and bruising to the front of the knee.[1] A person may also be unable to walk.[1] Complications may include injury to the tibia, femur, or knee ligaments.[2]

It typically results from a hard blow to the front of the knee or falling on the knee.[1] Occasionally it may occur from a strong contraction of the thigh muscles.[1] Diagnosis is based on symptoms and confirmed with X-rays.[3] In children an MRI may be required.[3]

Treatment may be with or without surgery, depending on the type of fracture.[2] Undisplaced fracture can usually be treated by casting.[2] Even some displaced fractures can be treated with casting as long as a person can straighten their leg without help.[2] Typically the leg is immobilized in a straight position for the first three weeks and then increasing degrees of bending are allowed.[2] Other types of fractures generally require surgery.[2][4]

Patella fractures make up about 1% of all broken bones.[3] Males are affected more often than females.[3] Those of middle age are most often affected.[3] Outcomes with treatment are generally good.[2]

Diagnosis[edit]

A vertical patella fracture with the fracture line marked by a black arrow

Diagnosis is based on symptoms and confirmed with X-rays.[3] In children an MRI may be required.[3]

Treatment[edit]

Treatment may be with or without surgery, depending on the type of fracture.[2]

Conservative[edit]

Undisplaced fracture can usually be treated by casting.[2] Even some displaced fractures can be treated with casting as long as a person can straighten their leg without help.[2] Typically the leg is immobilized in a straight position for the first three weeks and then increasing degrees of bending are allowed.[2]

Surgery[edit]

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, while any ligaments or tendons that had been connected to the removed portion are connected to the remaining portion. The fracture may require tension band wiring (in case of two part fracture) to unite the fractured bones. With advancement of fixation technique comminuted fracture of the patella are being reconstructed (patella saving operations).

References[edit]

  1. ^ a b c d e f g h "Patellar (Kneecap) Fractures". OrthoInfo - AAOS. January 2017. Archived from the original on 16 October 2017. Retrieved 16 October 2017. Cite uses deprecated parameter |deadurl= (help)
  2. ^ a b c d e f g h i j k l m n 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.
  3. ^ a b c d e f g h i j Abbasi, David. "Patella Fracture - Trauma". Orthobullets.com. Archived from the original on 17 October 2017. Retrieved 16 October 2017. Cite uses deprecated parameter |deadurl= (help)
  4. ^ 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.

External links[edit]

Classification
External resources