Patellar Fracture, Adult

A patellar fracture is a break in the little round bone (kneecap) that is the bump on the front of your knee. A direct blow to the knee, or fall, is usually the cause of a broken patella. Sometimes, a very hard and strong bending of the knee (like jumping events in sports) can cause a fracture. Usually the knee is tender and swollen and has pain with motion, especially trying to straighten out the leg. There may be difficulty walking or putting weight on the affected side. These fractures generally heal in about 4 to 6 weeks.

DIAGNOSIS

The diagnosis is usually easily made with an exam and x-ray.

TREATMENT

Treatment is dependent on the type of fracture:

  • If the fracture is undisplaced or only slightly displaced (this means the position of the parts is good) then, after any blood in the joint has been removed, and if you can still straighten your leg out, you can usually be treated with a splint or cast for 4 to 6 weeks. Straightening out your leg is called extension and the ability to do this is with the extensor mechanism. Every day while in treatment quadriceps exercises should be performed, or as directed by your caregivers.

  • If there is a stellate (comminuted) fracture of the patella (this means the patella is in multiple small pieces), the blood in the joint may be removed and if you are able to straighten your leg, you can usually be treated with a splint or cast for 4 to 6 weeks. Sometimes this type of fracture may be treated by removing the patella. You will still have a good knee without a patella. If this is done the knee still will need to be in a plaster cast or splint for the next 4 to 6 weeks.

  • If the fracture is a displaced transverse fracture and you cannot extend (straighten out your leg), then an operation is required to hold the bony fragments together until they heal. Again a plaster cast or splint is worn until the extension mechanism of the knee is regained. This means the knee is healed and you can straighten out your leg again normally.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

  • Warning: Do not drive a car or operate a motor vehicle until your caregiver specifically tells you it is safe to do so.

HOME CARE INSTRUCTIONS

  • You may resume normal diet and activities as directed or allowed.

  • Keep ice packs (a bag of ice wrapped in a towel) on the knee for twenty minutes, four times per day, for the first two days.

  • Change dressings if necessary or as directed.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

  • Use crutches as directed and exercise leg as directed.

  • Keep appointments as directed.

SEEK IMMEDIATE MEDICAL CARE IF :

  • Redness, swelling, or increasing pain in the knee.

  • An unexplained oral temperature above 102° F (38.9° C) develops.