What is a Patellar Fracture?
The kneecap or patellar is the largest sesamoid bone in the body and one of the components of the knee joint, present at the front of the knee. The undersurface of the kneecap and the lower end of the femur are coated with articular cartilage, which helps in smooth movement of the knee joint. The kneecap protects the knee and provides attachment to various muscle groups of the thigh and leg. Fracture of the kneecap is rare and is more common in adult males.
Causes of Patellar Fracture
The most common cause of fracture is a direct blow to the kneecap such as a fall or a motor vehicle accident. The patellar can also be fractured indirectly, due to a sudden contraction of the thigh muscles.
Symptoms of Patellar Fracture
Pain and swelling are the predominant symptoms of a patellar fracture. A few patients may also experience inability to walk and difficulty in straightening the knee. Sometimes, bruising may also be seen around the fracture site.
Diagnosis of Patellar Fracture
The diagnosis of a patellar fracture comprises of a physical examination, history of the injury and X-ray imaging to determine the nature and severity of the fracture. X-ray is the most common and widely used diagnostic tool for identification of fractures.
Treatment of Patellar Fracture
The treatment of patellar fracture depends upon the severity and nature of the fracture.
Non-surgical treatment can be used when the patellar has not been fragmented or displaced. Casts or splints may be used to straighten the knee and help in the healing process. Immobilization of the affected limb for 6 to 8 weeks may also be recommended.
Surgical treatment is needed if there is displacement of fractured fragments of the bone or the distance between the fractured parts is too far and would fail to heal. Immediate surgery is recommended in case of open fracture where the fractured site is exposed through the skin. The type of procedure to be conducted depends on the nature of the fracture. Transverse fractures are fixed with the help of wires and pins and a "figure-of-eight" configuration tension band while in a comminuted fracture, the small bone fragments are removed from the knee joint.
Rehabilitation after Patellar Fracture Treatment
Rehabilitation plays a vital role in helping patients resume their daily activities, after healing of the fracture. Treatment of the fracture may cause stiffness of the joint and weakness of the muscles. Physical therapy, joint mobilization and muscle strengthening exercises or weight-bearing exercises are helpful in regaining strength and preventing deformities.