Appointment Center (303) 436-4949

 

Patella Fracture

(Broken Kneecap; Fracture, Patella; Kneecap Fracture; Patellar Fracture)

Pronounced: pah-TEL-ah FRAK-choor

Definition

A patella fracture occurs when there is a break in the patella, better known as the kneecap. The patella is a large, movable bone at the front of the knee.

The Kneecap
si55550925_96472_1

Copyright © Nucleus Medical Media, Inc.

Causes  ^

Some common causes of this injury include:

  • Sharp blow to the knee
  • Excessive stress on the knee

Risk Factors  ^

Factors that may increase your risk of a patella fracture include:

  • Increased age
  • Postmenopause
  • Decreased muscle mass
  • Decreased bone mass— osteoporosis
  • Participation in contact sports such as football and soccer
  • Obesity, which places strain on muscles, bones, tendons, and ligaments
  • Violence, such as car or car-pedestrian accidents

Symptoms  ^

Patella fracture may cause:

  • Sudden, excruciating pain in the kneecap
  • Swelling, bruising, and tenderness
  • Inability to extend the knee
  • Difficulty walking

Diagnosis  ^

You will be asked about your symptoms and medical history. A physical exam will be done. The doctor will look closely at the knee to see if there are signs of fracture. A straight leg test may be done.

Images can evaluate your knee and surrounding structures. These may include:

Treatment  ^

Treatment options include the following:

Nonsurgical Approach

After the tests, the doctor will determined whether surgery is needed. If the patella is not badly injured, the doctor will place the knee in a cast. This cast may need to be worn for 6 weeks. After that, a knee brace and physical therapy will be needed. A cane or crutches may be needed.

Medication will be advised to reduce swelling and pain.

Surgery

If the patella is in pieces, then surgery will be needed. There are 2 kinds of surgery that are commonly used to treat this injury:

  • Open reduction-internal fixation surgery —The doctor uses pins and screws to put the broken pieces back together.
  • Patellectomy—Rarely, the doctor removes part of the kneecap or the entire kneecap.

After surgery, physical therapy will be needed. This can involve range-of-motion exercises and stretching. In some cases, another surgery will be needed to remove the pins and screws.

Depending on the injury, recovery can take weeks to several months.

Prevention  ^

To help reduce your chance of a patella fracture:

  • Do not put yourself at risk for trauma to the bone.
  • Do weight-bearing exercises to build strong bones.
  • Build strong muscles to support the knee, prevent falls, and to stay active and agile.
  • Wear proper padding and safety equipment when participating in sports or activities.
RESOURCES:

American Physical Therapy Association
http://www.orthopt.org

Ortho Info—American Academy of Orthopaedic Surgeons
http://orthoinfo.org

CANADIAN RESOURCES

Canadian Orthopaedic Association
http://www.coa-aco.org

Canadian Orthopaedic Foundation
http://www.canorth.org

REFERENCES:

Henry P, Panwitz B, et al. Rehabilitation of a post-surgical patella fracture. Physiotherapy. 2000;86:139-142.

Patellar (kneecap) fractures. Ortho Info—American Academy of Orthopaedics website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00523. Updated January 2017. Accessed August 30, 2017.

Stress fractures. The American College of Foot & Ankle Orthopedics & Medicine website. Available at: http://www.acfaom.org/information-for-patients/common-conditions/stress-fractures. Accessed August 30, 2017.

Tay G, Warrier S, et al. Indirect patella fractures following ACL reconstruction. Acta Orthopaedica. 2006;77:494-500.

Last reviewed August 2017 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM  Last Updated: 9/30/2013

Original text