The patella is one of three bones that make up the knee joint. It is helpful in providing strength when the knee joint is extended. The patella itself is strengthened by a lining of cartilage on the under side.
A patella fracture most often occurs from a fall onto the kneecap in a sporting accident, bicycle accident, pedestrian accident, or motorcycle accident. Kneecaps can also be fractured when they are twisted or forced into the dashboard in a car crash or truck crash.
Patella Fracture Treatment
When a patella fracture occurs, x-rays will be taken to determine the type of fracture and the degree of displacement. It is critical to determine if the patient can perform a straight leg raise. A straight leg raise test is done while the patient lies flat on a bed. With the leg straight, the patient is directed to raise their foot off the bed and hold it in the air. This is to test the function of the the quadriceps muscle and its attachment to the shin bone. If a straight leg raise can be done, there is a possibility surgery will not be necessary. The knee will need to be immobilized with a knee brace or long leg cast. This will also help to minimize pain and discomfort.
Inability to perform a straight leg test means there has been disruption of the quadriceps tendon, patella, or patellar tendon, meaning the knee will require surgery. During surgery, the fracture is aligned and held in place with a combination of pins, screws, and wires. Occasionally, a portion of the patella may be removed, but this is usually a small fracture fragment.
Patella Fracture Complications
The most common complication following surgery for a patella fracture is that the metal implant can be painful — especially when kneeling. Frequently a second surgery is performed to remove the metal implant. Other complications include:
- Loss of fixation
- Fractures that fail to heal
- Chondromalacia (kneecap pain)
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