fbpx

Patella Fracture

A patella fracture is a break in the kneecap or kneecap, the small bone at the front of the knee. Because the patella acts as a shield for the knee joint, you are vulnerable to fractures if you fall directly on your knee or hit it against the dash in a collision with a vehicle. A patellar fracture is a serious injury that can make it difficult or even impossible to straighten the knee or walk..

Some simple patellar fractures can be treated using a cast or splint until the bone heals.. In most patellar fractures, Nevertheless, pieces of bone move out of place when injury occurs. For these more complicated fractures, surgery is needed to restore and stabilize the patella and allow return of function.

The patella is a small bone located in front of the knee joint., where the femur meet (femur) and the warm (tibia). Protects the knee and connects the muscles of the front of the thigh with the tibia.

The ends of the femur and the bottom of the kneecap are covered with a soft substance called Articular cartilage . This cartilage helps the bones slide easily against each other as you move your knee..

Patella Fracture in Bogotá

La rótula puede fracturarse de muchas formas. Una fractura puede ser una rotura simple y limpia de dos piezas o el hueso puede romperse en muchos pedazos.

Puede ocurrir una fractura en la parte superior, central o inferior del hueso. A veces, las fracturas ocurren en más de un área de la rótula.

Tipos de fracturas rotulianas

Fractura estable. Este tipo de fractura no se desplaza. Los trozos de hueso pueden permanecer en contacto entre sí o estar separados solo por un milímetro o dos. En una fractura estable, los huesos generalmente permanecen en su lugar durante la curación.

Fractura desplazada. En una fractura desplazada, los extremos rotos del hueso se separan y no se alinean correctamente. La superficie de la junta normalmente lisa también puede romperse. Este tipo de fractura a menudo requiere cirugía para volver a unir las piezas de hueso.

Fractura conminuta. En este tipo de fractura, el hueso se rompe en tres o más pedazos. Según el patrón específico de la fractura, una fractura conminuta puede ser estable o inestable.

Fractura abierta. En una fractura abierta, el hueso se rompe de tal manera que los fragmentos de hueso sobresalen a través de la piel o una herida penetra hasta el hueso. Una fractura abierta a menudo implica daño a los tejidos blandos circundantes y puede tardar más en sanar.

Las fracturas abiertas son particularmente graves porque, una vez que se rompe la piel, existe un mayor riesgo de infección tanto en la herida como en el hueso. Se requiere tratamiento inmediato para prevenir infecciones

Complicaciones de las fracturas rotulianas

Incluso después de un tratamiento exitoso, algunos pacientes con fracturas rotulianas pueden experimentar complicaciones a largo plazo.

Artritis postraumática

La artritis postraumática es un tipo de artritis que se desarrolla después de una lesión. Incluso cuando sus huesos sanan normalmente, el cartílago articular que los recubre puede dañarse, lo que provoca dolor y rigidez con el tiempo. La artritis severa ocurre en un pequeño porcentaje de pacientes con fracturas rotulianas. La artritis leve a moderada, una afección llamada condromalacia rotuliana, es mucho más común.

Debilidad muscular

Algunos pacientes pueden tener debilidad permanente del músculo cuádriceps en la parte delantera del muslo después de una fractura. También es común cierta pérdida de movimiento en la rodilla, que incluye tanto enderezamiento (extensión) como flexión (flexión). Esta pérdida de movimiento no suele ser incapacitante.

Dolor crónico

El dolor prolongado en la parte delantera de la rodilla es común en las fracturas rotulianas. Si bien no se comprende completamente la causa de este dolor, es probable que esté relacionado con artritis postraumática, rigidez y debilidad muscular. Algunos pacientes encuentran que se sienten más cómodos usando una rodillera o soporte.

Bogota Patella Fracture
Patella Fracture

Patella Fracture in Colombia

Because the kneecap (ball joint) acts as a shield for the knee joint, can be easily broken. Fall directly onto the knee, for example, is a common cause of patellar fractures.

These fractures are serious injuries and often require surgery to heal.. Long-term, can cause arthritis in the knee.

The patella is a small bone located in front of the knee joint., where the thigh bone meets (femur) and the warm (tibia). Protects your knee and connects the muscles of the front of the thigh with the tibia.

The ends of the femur and the bottom of the kneecap are covered with a slippery substance called articular cartilage.. This helps the bones slide smoothly against each other as you move your leg.

Types of patellar fractures

Patellar fractures vary. The kneecap may crack slightly or break into many pieces.

A kneecap tear can occur at the top, central or lower bone. Sometimes, fractures occur in more than one area of ​​the patella.

Stable fracture. This type of fracture does not move. The broken ends of the bones come together properly and are aligned. In a stable fracture, bones usually stay in place during healing.

Displaced fracture. When a bone breaks and shifts, broken ends come apart and don't line up. This type of fracture often requires surgery to put the pieces back together..

Comminuted fracture. This type of break is very unstable. The bone breaks into three or more pieces.

Open fracture. In this type of fracture, the skin has broken away exposing the bone. These injuries often involve much more damage to the muscles, surrounding tendons and ligaments. Open fractures have a higher risk of complications and take longer to heal.

Patellar fractures are most often caused by a direct blow, such as a fall or collision from a motor vehicle. The patella can also be fractured indirectly. For example, the thigh muscles can contract so violently that they separate the kneecap.

Knee fracture refers to fractures of any of the parts of the bone involved in the joint itself. This includes fractures of:

  • Ball joint : represents the 1% of all the fractures, most common among 20 and the 50 years.
  • Femoral condyles : These tend to fracture when the knee is stressed.
  • Tibial eminence : caused by accidents, like a blow to the proximal tibia when the knee is flexed, or if the knee is hyperextended during an accident. It is generally seen in patients with 8 a 14 years.
  • Tuberosidad tibial : more common in men than women and in patients younger than adults; often seen in athletes, especially those involved in jumping sports.
  • Tibial plateau : compression fractures of the articular surface, typically by extreme force, such as falling from a height or being hit by a vehicle, although minimal force may be necessary in patients with osteoporosis.
  • Second Fracture : it is an avulsion fracture of the lateral tibial condyle just beyond the articular surface with the knee. Although not directly part of the knee joint, occurs in association with anterior cruciate ligament tears (LCA), medial meniscus and lateral capsular ligament, for what is included here.

Knee fracture can result in neurovascular compromise or compartment syndrome. Soft tissue infection or osteomyelitis with open fractures can occur. Other complications include pseudoarthrosis, late consolidation, osteoarthritis, necrosis avascular, fat embolism and thrombophlebitis. See also separate article Complications from fractures .

Fractures around the knee are common in children, but the pattern of knee fractures is different. The relatively high proportion of cartilage in growing children can make diagnosis difficult, especially on plain radiographs, and stress x-rays or MRIs may be necessary

Patella Fracture Procedure

Non-surgical treatment

If the pieces of broken bone have not been displaced by the force of the injury, you may not need surgery. Cast or splints can be used to keep the knee straight. This will keep the broken ends in the proper position while they heal.

You will not be able to put any weight on your leg until the bone is completely healed. This can lead to 6 a 8 weeks, and maybe more. Most people use crutches during this period.

Surgical treatment

If the kneecap has separated (displaced), you will most likely need surgery. Fractured patellar bones that are not close together often have a hard time healing or may not heal. The thigh muscles that attach to the top of the kneecap are very strong and can pull the broken pieces out of place during healing.

Time of surgery. If the skin around the fracture has not been broken, your doctor may recommend that you wait until the abrasions have healed before having surgery. Nevertheless, open fractures expose the fracture site to the environment. They need an urgent cleaning and require immediate surgery.

Procedure. The type of procedure that is done often depends on the type of fracture you have. Before the surgery, your doctor will talk with you about your procedure, as well as possible complications.

  • Transverse fracture. These two-part fractures are usually fixed in place by pins and wires and a tension band setting in “figure eight”. Figure eight band presses the two pieces together.

    This procedure is best for treating fractures near the center of the kneecap.. The fracture fragments at the ends of the patella are too small for this procedure. Breaks in many parts can be over-compressed by the tension band.

    Another approach to a transverse fracture is to secure the bones with small screws., wires and pins. In many cases, these wires and pins will need to be removed approximately one to two years after surgery.

  • Comminuted fracture. In some cases, the top or bottom of the kneecap can be broken into several small pieces. This type of fracture occurs when the kneecap is separated from the injury and then crushed by falling on it..

    Because the bone fragments are too small to put back in place, will be extracted. Your doctor will attach the loose tendon to the remaining patellar bone..

    If the kneecap is broken into many pieces in its center (and they are separated), your doctor may use a combination of wires and screws to fix it. Removing small portions of the patella can also have good results. Complete removal of the patella is the last resort for treating a comminuted fracture.

Bogota Knee Fracture

Patella Fracture

PATELLAR FRACTURES (KNEES)

Because the kneecap (ball joint) acts as a shield for the knee joint, can be easily broken. Fall directly onto the knee, for example, is a common cause of patellar fractures.

These fractures can be treated with a brace or surgery., depending on the severity of the injury. Long-term, some kneecap injuries have an increased risk of developing knee arthritis.

Patella fracture

Patella, which in anatomy is called the patella, is a small, flat, triangular-shaped bone found in the front of the knee, articulated with the tibia and in contact with the femur and covered by cartilage, whose function in the joint is to facilitate flexion and extension movements.

It is the most exposed part of the kneecap and actually acts as a bumper for the knee., therefore the risk of fracture is important in the event of strong direct trauma, such as those that can occur in a traffic accident or in sports, like football, rugby or ski. Sometimes the patella fracture can occur indirectly as a result of a violent pulling movement of the quadriceps (stress fractures, that usually occur in athletes).

The patella fracture requires immediate attention, fundamentally due to causing acute and intense pain and a more than significant functional disability of the joint. Other common symptoms are knee inflammation, feeling popping and abnormal mobility. Its clinical classification is made according to the place and direction of the tear and whether there has been greater fragmentation.

For diagnosis, palpation would often suffice, as the fracture line can be identified with the finger, but X-rays provide greater diagnostic precision, since they allow to determine if there is multiple fragmentation of the bone. The scanner provides the precise image of all the fragments originated by the fracture. On the other hand, in the event that the bone breakage has been caused by stress or indirect trauma, MRI will allow an assessment of the knee joint to assess other possible ligament or meniscus injuries.

Frequently Asked Questions about: Patella Fracture

Common Questions and Answers about Patella Fracture

The patella or patella is the largest sesamoid bone in the body and one of the components of the knee joint, present on the front of the knee. The lower surface of the patella and the lower end of the femur are lined with articular cartilage, which helps the smooth movement of the knee joint. Patella protects the knee and provides support to various muscle groups in the thigh and leg. Patella fracture is rare and more common in adult men.

Patients with undisplaced fractures (not separated) or minimally displaced who can perform a straight leg raise (as described above) can usually be treated without surgery. A long leg cast or knee immobilizer may be used to treat these types of patellar fractures..

When is the surgery needed, an incision is made in the front of the knee joint. The fractured ends of the bone are realigned and held in place with a combination of pins, screws and wires. 1 In some cases, you can simply remove a part of the patella, but this is usually done for smaller fracture fragments.

Patella fractures can cause severe pain and difficulty walking. Some of the more common symptoms of this injury include:

  • Pain : patella fractures are generally quite uncomfortable. Keeping the knee straight can significantly help with discomfort, and bending the joint is usually very painful.
  • Swelling : swelling and bruising around the front of the knee are typical of a patella fracture. Often, as the days go by, swelling spreads up the leg and even to the foot. It is not uncommon for bruises to also spread to the calf and foot for several days.
  • Inability to lift the leg : The most common test to diagnose this injury is called a straight leg lift test.. This test finding may be present with other injuries, but it can help determine when treatment is needed.
  • A palpable defect in the kneecap : depending on the type of fracture, kneecap damage can sometimes be felt through the skin. The ability to feel the fracture of the patella is easier shortly after the injury before the swelling becomes more significant.

Knee fractures are usually caused by a specific sudden injury, like a fall or a high speed collision. Most people know that something is wrong as soon as the injury occurs.

A fractured kneecap tends to cause immediate pain, as well as other symptoms, What:

  • Immediate swelling and bruising
  • Difficulty bending the knee or placing weight on the affected leg
  • A scraping or grinding sensation during movement.
  • Muscle spasms

In some cases, the broken bone will be visible through the skin. In other cases, knee looks the same as always, but it doesn't work normally.

A fractured kneecap should always be immediately evaluated by a doctor. A simple knee fracture can heal on its own, although a cast may be necessary to prevent parts from moving. A more complex fracture, on the other hand, may require surgery to secure the bones in place and restore stability to the knee. An orthopedic physician who specializes in diagnosing and treating knee injuries can provide a personalized treatment recommendation..

If you recently injured your knee and think you may be dealing with a fracture, You can turn to Advanced Orthopedics and Sports Medicine for rapid diagnosis and treatment. We offer comprehensive imaging services on site, as well as surgical and non-surgical treatments. From custom braces and physical therapy to medication management and laparoscopic surgery, we offer the latest therapies for common and complex knee injuries

The kneecap can fracture (break) in various ways, for example, if it falls on the knee; gets hit while playing sports like soccer or rugby; or during a car accident.

Symptoms include:

  • Bruises
  • Not being able to stretch or lift the knee while it is straight
  • Can not walk

Patella (ball joint) is a triangular bone in the front of the knee. Various tendons and ligaments connect to the patella, including those attached to the bones of the upper leg (femur) and the lower leg (tibia).

Although the kneecap is not necessary for walking or bending the leg, makes muscles more efficient and absorbs much of the stress between the upper and lower leg. Climbing stairs and squatting can put up to seven times your normal body weight on your kneecap and the joint behind it.

Patella fractures represent approximately the 1 percent of all skeletal injuries. The kneecap can be fractured in many ways: partial or completely, in a few or many pieces. Sometimes, when the kneecap is fractured, ligaments or tendons attached to it can twist or break.

Symptoms can include:

  • Severe pain in and around the kneecap.
  • Swelling
  • Pain when moving the knee in both directions.
  • Difficulty extending the leg or lifting the straight leg
  • A deformed appearance of the knee due to fractured parts.
  • Tenderness when pressing the patella.

Two types of surgery can be done to repair a fractured kneecap:

Open reduction-internal fixation surgery (ORIF): the surgeon opens the skin and reattaches the broken bones with wires, metal nails or screws. Pieces of broken bone too small to be repaired are removed. If the kneecap is so badly fractured that it cannot be repaired, it may be fully or partially removed.

Once the bones have joined, the opening closes, a sterile bandage is placed over the area and the knee is placed in a cast or other device so that it cannot move while it heals.

Sometimes, especially in thin patients, The wires, dowels or screws can be irritating. In this case, the devices will be removed after the patella has fully healed.

Total or partial pathelectomy: this two-hour procedure removes all or part of the patella. If your surgeon finds that the fracture is too severe to repair, remove damaged bone pieces.

Surgery preserves the quadriceps tendon above the patella, the patellar tendon below and other soft tissues around the patella. After this surgery, will be able to extend the knee, but the extension will be weaker.

Once your kneecap has healed, strengthening the muscles around the knee can help prevent further injury. Playing contact sports or doing other activities that put pressure on the knee can increase the risk of another kneecap injury.. You should avoid these activities or wear a knee brace to cushion the blow when playing contact sports.

Physiotherapy , learning ways to avoid stress on the knee and continuously strengthening and conditioning the leg muscles can help prevent further knee injuries.

Best exercise options are low-impact and weight-bearing, like stationary bikes and certain weight lifting programs, so that the knees do not have to absorb the impact.

Stable fracture. This type of fracture does not move. The pieces of bone may stay in contact with each other or be only a millimeter or two apart. In a stable fracture, bones usually stay in place during healing.

Displaced fracture. In a displaced fracture, the broken ends of the bone pull apart and don't line up properly. The normally smooth joint surface can also be broken. This type of fracture often requires surgery to reattach the pieces of bone..

Comminuted fracture. In this type of fracture, the bone breaks into three or more pieces. According to the specific pattern of the fracture, a comminuted fracture can be stable or unstable.

Open fracture. In an open fracture, the bone breaks in such a way that bone fragments protrude through the skin or a wound penetrates to the bone. An open fracture often involves damage to the surrounding soft tissues and may take longer to heal..

Open fractures are particularly serious because, once the skin is broken, there is an increased risk of infection both in the wound and in the bone. Immediate treatment is required to prevent infection.

Son fracture-dislocation. The fracture trace begins at a tibial plateau, crosses the base of the spine and ends in the cortex on the opposite side. May be associated with ipsilateral lateral ligament tear. Internal ones are more frequent than external ones.

  • Extraarticulares, supracondylum o metaphysicians: They are those that settle in the area of ​​widening of the medullary canal. They are usually displaced due to muscle traction. The popliteal vascular-nerve bundle may be compromised.
  • Intraarticulares, epiphysicians or condyleas: They are produced by a shear mechanism, two forces acting in opposite directions. Depressions affecting the growth plate in children are rare. We distinguish:
  1. Complete.
  2. Incomplete:
  • Unicondíleas in the sagittal plane: They affect only one of the joint plateaus. Cruciate ligament can tear on the same side.
  • Fractura osteocondral: The patella strikes the condyle tangentially.
  • Hoffa fracture: Unicondílea (only affects one articular condyle) in the frontal plane, where the condylar cap is rotated, pulled by the twin.
  • Supraintercondíleas o bicondíleas: They are given in a V shape, Y o T. They usually occur in high-energy trauma, which in the most severe forms lead to comminuted fractures, with small pieces, then requires surgical treatment. The shaft fragment of the femur usually ends in a beak, and rips the quads and the skin, inside out.
  • Epiphysiolysis: They affect the growth plate. They are produced by traffic accidents in children and sports accidents in adolescents. They are classified according to grades I to V of Salter and Harris.

Patella is a triangular shaped bone that protects the anterior part of the knee like a shield, in addition to having an aesthetic function, serves as a fulcrum for the quadriceps tendon: This increases your lever arm and allows you to stretch and flex your knee properly.

It is part of the family of "sesamoid" type bones (smooth bones, rounded and small that are embedded in a tendon). In fact, is the sesamoid bone larger of the human body and is designed to withstand very high loads. Thanks to her we can walk, run and jump normally

  • External tibial plateau fractures: They are the most frequent. According to the fracture line they are divided into:
    • Linear in the sagittal plane. They are normally associated with a fracture of the head of the fibula.
    • Hulten's or subsidence fractures. Joint surface sags, but the outer cortex is preserved. In the most severe forms, the meniscus slides into depression.
    • Mixed fractures. They are the most serious. They are associated with the rupture of the external lateral ligament, and sometimes, the articular surface collapses en bloc and breaks into multiple fragments, which greatly worsens the prognosis of functional recovery.
  • Internal tibial plateau fractures: They are less frequent than the previous ones. Are divided into:
    • Linear in the sagittal plane: those with the fracture line going below the insertion of the internal lateral ligament will have the best prognosis, since they can be reduced by orthopedic maneuvers.
    • Subsidence fractures: the least frequent in this group.
    • Mixed: similar to those on the outer plate.

The knee is stabilized by the lateral ligaments, cruciate ligaments, other smaller ligaments and the joint capsule. When a knee dislocation occurs, it means that multiple ligaments have been injured and stopped performing their function.

This injury occurs from high energy injuries, sports accidents and traffic accidents. Its treatment is complex, because no two dislocations are ever the same, the number of injured ligaments always varies (it can be three, four…). The only thing that is certain is that in more than one 90% of the cases will require a surgical intervention for their recovery. In this video we will give you more details about knee dislocation.

Non-surgical treatment

If the pieces of bone are not out of place (displaced), you may not need surgery. Your doctor may put you in a cast or splint to keep your knee straight and help prevent movement of your leg.. This will keep the broken ends of the bone in the proper position while they heal..

Depending on your specific fracture, you may be allowed to put weight on your leg while wearing a cast or brace. Nevertheless, with some fractures, weight bearing is not allowed during 6 a 8 weeks. Your doctor will discuss weight bearing restrictions with you..

Surgical treatment

If the pieces of bone are out of place (displaced), you will most likely need surgery. Fractured patellar bones that are not close together often have a hard time healing or may not heal. The thigh muscles that attach to the top of the kneecap are very strong and can pull the broken pieces out of place during healing.

Time of surgery. If the skin around the fracture has not been broken, your doctor may recommend that you wait until the abrasions have healed before having surgery.

Nevertheless, open fractures have an increased risk of infection and are scheduled for surgery as soon as possible, usually in a few hours. During surgery, injury cuts and bone surfaces are thoroughly cleaned. In general, the bone will be repaired during the same surgery.

Surgical procedures

The type of procedure that is done often depends on the type of fracture you have. Before the surgery, your doctor will talk with you about your procedure, as well as possible complications.

Transverse fracture. These two-part fractures are most often fixed in place using screws or dowels and wires and a tension band setting in “figure eight”. Figure eight band presses the two pieces together.

This procedure is best for treating fractures near the center of the kneecap.. The fracture fragments at the ends of the patella are too small for this procedure. Breaks in many parts can be over-compressed by the tension band.

Another approach to a transverse fracture is to secure the bones with small screws or small screws and small plates..

Our specialties

Meet our Portfolio of Services and Specialties focused on Orthopedics and Traumatology of the Shoulder and Knee.

Previous
Next

Agreements

Our extensive experience and reliability has allowed us to strengthen ties and generate Agreements with recognized institutions providing Trust and Safety to Our patients.

Orthopedist and Traumatologist

Agenda

Your question

Total attendance

Schedule your Appointment with him Dr. Danilo Velandia to be able to provide you with information and guidance about our Procedures. All the necessary information will be explained to you from: how to prepare for surgery, what will happen to you at the Clinic or Hospital, how you should take care of yourself at the end of the Procedure, as well as the changes that must occur in your lifestyle.

Testimonials from our patients

I broke my left rotator cuff while falling. I tried to put up with it for almost a year with medications, physical therapy and basically it didn't help . I was scheduled for surgery elsewhere. I did not like the atmosphere, so I looked for another opinion. I am happy to have done it !! all nursing staff, ambulatory surgical units, postoperative care and now the final results: I have no pain I have a full range of motion, I have strength and continue to develop it while following a very detailed therapy regimen. I can only recommend Dr.. Danilo Velandia and elite staff, professional, personal, warm and friendly.

Customer Logo
Camila cardenas Orthopedics and Traumatology Patient

I am so impressed and grateful for the care that Dr.. Danilo, that every time I get a chance to give a positive review, I can not resist! The level of care he provides far exceeds that of any other doctor I have ever seen. I am so impressed. He patiently explained every detail of the treatment plan for my broken Knee to me and really took the time to listen and answer all the questions I had.. If I ever have to refer someone I know to an orthopedic surgeon, I will insist that they see Dr.. Danilo Velandia. There is no one else I would turn to if I needed one again. Thank you Dr. Danilo for the great care you have given me!

Customer Logo
Raul CespedesOrthopedics and Traumatology Patient

I have seen Dr.. Danilo Velandia a couple of times in Bogotá and I'll be back, it's been great so far. No pressure to rush to surgery, great advantage. Gives good information and options from the first day to the surgery process. All staff are friendly and helpful highly qualified, He has been the most proactive and helpful medical person I have dealt with and I am really very happy. Your diligence has made sure you get the help you need, and it even helped me avoid forgetting things. Thank you very much indeed! I am very happy with my visits with him. Highly recommended Dr. Danilo Velandia and his team of professionals!

Customer Logo
Pedro Mutis Orthopedics and Traumatology Patient

My experience as a patient of Dr.. Daniel has been extremely positive. Performed surgery on my right shoulder, completely relieving my symptoms. He patiently listened to my concerns, answered my many questions and provided insightful information, but not too technical. The doctor. Danilo made himself available both before and after my surgery to address my pre-surgery nerves and my post-surgery expectations.. He was always professional, patient and attentive. I feel very lucky that when I could no longer suffer with the symptoms, my husband, who recommended me to Dr.. Danilo Velandia.

Customer Logo
Maria lopezOrthopedics and Traumatology Patient

After playing competitive soccer for several years, I broke my anterior cruciate ligament and meniscus. I was very nervous about the long process of surgery and recovery really is a life changing process, I thought I would lose everything since sport is my life and my passion, but Dr.. Danilo Velandia was very helpful, informative and reassuring, he really knew how to handle the situation. My surgery went smoothly and my recovery went according to plan. The doctor. Danilo was present every step of the way and showed his medical competence, as well as his natural compassion, Thank you very much and very grateful, I have been able to continue with my day to day.

Customer Logo
Andres PereaOrthopedics and Traumatology Patient
Open chat