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Kneecap Fracture

A complete or incomplete break in the upper or lower portion of the patella (kneecap). Most fractures of the patella are accompanied by sprain or rupture of ligaments or tendons attached to the patella

. A fracture of the patella is an injury to the kneecap. The kneecap bone is one of three bones that make up the knee joint. The patella is lined with cartilage on its undersurface, and is important in providing strength of extension of the knee joint.

BODY PARTS INVOLVED

• Patella.
• Knee joint.
• Soft tissue surrounding the fracture site, including nerves, tendons, ligaments and blood vessels.

Causes

Direct blow or indirect stress to the kneecap. Indirect stress may be caused by twisting or violent muscle contraction.

A patella fracture most often occurs from a fall onto the kneecap. When this occurs, the fracture can be associated with abrasions and lacerations to the skin overlying the injury. Patella fractures can also occur when the quadriceps muscle is contracting but the knee joint is straightening (a so-called ' eccentric contraction'). When the muscle pulls in this manner, the patella can fracture.

Signs & Symptoms

• Severe pain at the fracture site.
• Pain when moving the knee forward or backward.
• Swelling around the fracture.
• Visible deformity if the fracture is complete and bone fragments separate enough to distort normal knee contours.
• "Catching" or locking of the knee.
• Tenderness when pressing the kneecap against underlying bones.
• Numbness and coldness beyond the fracture site if the blood supply is impaired.
• Inability to walk.

Treatment

Follow your doctor's instructions. Instructions are supplemental.

• Immobilization will be necessary. A rigid cast will be used from the upper leg to the ankle.
• After the cast is removed, use frequent ice massage. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a softball. Do this for 15 minutes at a time, 3 or 4 times a day, and before workouts or competition.
• Apply heat instead of ice, if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments or ointments.
• Take whirlpool treatments, if available.

MEDICATION

Your doctor may prescribe:

• General anesthesia or local anesthesia for surgery to remove fractured patella fragments.
• Narcotic or synthetic narcotic pain relievers for severe pain.
• Stool softeners to prevent constipation due to inactivity.
• Acetaminophen (available without prescription) for mild pain after initial treatment.

Home Diet

• Drink only water before manipulation or surgery to treat the fracture. Solid food in your stomach makes vomiting while under general anesthesia more hazardous.
• During recovery ,eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.

Do's and Don't's

• Apply a sterile dressing to open wounds.
• Don't move the patient unless the injured area is completely immobilized.
• Don't attempt to straighten a misshapen bone or joint or to change its position.
• Don't test a misshapen bone or joint for loss of function.

Prevention Tips

• Build adequate muscle strength and achieve good conditioning prior to exercise, athletic practice or competition. Increased muscle mass helps protect bones and underlying tissue.
• Use appropriate protective equipment, such as knee pads, when participating in contact sports .