A knee fracture, is a broken bone in or around the knee joint. This can affect the tibia (leg), the kneecap (patela) or the femur (thigh bone) where they connect with the knee.
Knee fracture surgery (knee osteosynthesis) It is a surgical procedure that is performed to correct the position of broken bones. (anatomical reduction) in or around the knee to restore normal function, stability and movement.
The kneecap is a bone that connects the bones of the thigh and the leg.. The function of the patella or patella, is to facilitate the extension of the knee, and also protect the joint, acting as a shield. Thigh bones, kneecap and legs, on their surfaces, are covered with articular cartilage and synovial fluid, that allow smooth movement of the bones when walking. Because the kneecap is a shield, you can be injured by falling or tripping. Knee fractures vary not only in the damaged area, but also in the extent of the damage. The kneecap could slightly snap or break into pieces. It could happen at the top, central or lower kneecap. It could also exist in many parts of the patella. Other variations may be stable fracture, displaced fracture, open fracture and comminuted fracture. In stable fracture undisplaced fracture, broken pieces would line up and also stay in place during the healing or consolidation process. In a displaced fracture, broken pieces are not aligned but separated. Often, this requires surgical correction.
In open fractures, the skin can be opened to make the bone visible. This occurs during excessive damage and is complicated by the risk of infection.. Comminuted fractures, is called, when the bone breaks into three or more pieces, usually require surgery.
La mayoría de las fracturas de rodilla se producen por un golpe directo . Las causas más comunes de fracturas de rodilla incluyen caídas, accidentes automovilísticos (frecuente en caídas o colisión en motocicletas) actividades deportivas (ciclismo) o incluso contracciones musculares severas en casos raros.
Algunas de las cirugías habituales empleadas para el tratamiento de una fractura de rodilla incluyen:
Luxación de la rodilla
Se trata de una lesión relativamente rara, pero de gran importancia, es le resultado de la perdida de las relaciones normales entre el fémur y la tibia. Es casi siempre causado por eventos traumáticos de gran intensidad, caídas de gran altura, accidentes en deportes extremos, accidentes en motocicletas o automóviles. Se pueden asociar a fracturas e incluso a lesiones vasculares, como el daño de la arteria principal de la rodilla (arteria poplítea), que puede comprometer la extremidad. una lesión vascular grave. La luxación de la rodilla es una urgencia, que debe ser tratada de inmediato para evitar complicaciones.
Luxación rotuliana / Luxación de la rotula
Esto es común, especialmente en individuos activos jóvenes, mas frecuente en mujeres. Existen diversas causas, entre ellas los traumas directos, y así mismo, existen factores que puede predisponer a una persona para tener luxación de la rotula, cómo son loa displasia femoral (alteración congénita en el desarrollo del fémur). La mayoría de las luxaciones son laterales y se acompañan de dolor, limitación para la movilidad y efusión o hinchazón. El daño a los ligamentos mediales es común. La luxación o dislocación también puede ocurrir cuando el pie se ancla o planta en el suelo y se produce un cambio rápido de dirección o una torsión en la rodilla . Por lo general, existe laxitud ligamentosa preexistente y, cuando la luxación rotuliana ha ocurrido una vez, puede reaparecer debido a la consiguiente lesión del ligamento. La reubicación en el surco rotuliano suele ser espontánea cuando se extiende la rodilla.
Lesión o ruptura de ligamentos laterales (ligamento colateral medial y ligamento colateral externo) Los ligamentos de la parte interna y externa de la rodilla, son muy importantes, permiten y contribuyen a la estabilidad de la rodilla cuando estamos de pie o caminando.
Los ligamentos de la rodilla en la parte interna son conocidos como complejo ligamentario o esquina postero interna o posteromedial, de igual forma , los ligamentos de la parte externa o lateral de la rodilla se conocen como complejo ligamentario o esquina Posterolateral.
La ruptura de los ligamentos, se produce casi siempre por traumas de alta energía como caídas de alturas, accidentes de tránsito, deportes extremos, o incluso en prácticas deportivas comunes cómo el fútbol.
En fracturas complejas de la rodilla, estos ligamentos pueden estar comprometidos, para lo cual es necesario, realizar la reparación de los tejidos lesionados. Cuando la ruptura de los ligamentos, no se trata, y existe inestabilidad, la reconstrucción con injertos es necesario.
Femur fracture
The femur is the thigh bone, connects hip to knee. It is a strong bone that supports significant loads. Fractures of this bone, they are usually traumas of significant magnitude.
Tibial fracture
The tibia is the main leg bone, is closely related to the fibula, connects the knee with the foot at the ankle . It is a strong bone that supports significant loads. Fractures of this bone, they are usually traumas of significant magnitude.
Patella
Patella (patela) it's a sesamoid bone, located in the anterior part of the lower extremity, acts as a shield for the knee joint, and also, like a lever on the knee. Is exposed to direct trauma.
knee fractures, are serious injuries and often require surgery to heal (consolidation). Long-term, can cause osteoarthritis in the knee, due to loss of articular cartilage.
Knee Fractures Vary, from undisplaced fractures, multiple fractures (break into many pieces) and open fractures, high-energy with higher probability of complications.
Knee fractures can occur, search for, within the joint or combinations of the two above, or even, can occur in more than one bone.
Stable fracture. This type of fracture does not move. The broken ends of the bones stay together and are aligned. In a stable fracture, bones generally remain in place during healing or 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 reattach the fragments..
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 is opened and the bone is exposed to the environment, which implies a higher risk of complications.
Knee fracture refers to fractures of any of the parts of the bone involved in the joint itself. This includes fractures of:
A fracture of the femur - the strongest bone in the body - is usually obvious because it takes a lot of force to break. But fractures of the tibia - the most weight-bearing bone in the lower leg - and the bone along the tibia, below knee (fibula) they can be more subtle.
Signs and symptoms of a knee fracture may include the following:
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
If the fractured bone fragments, have not been displaced by the force of the injury, you may not need surgery. Cast or splints may be used to maintain position, and thus avoid its displacement. Similarly, weight will be limited to your leg until the bone is completely healed.
If the bone fragments, they shift and lose their continuity, you will most likely need surgery, in order to reposition , and get back in shape, length and function, for which, usually, the use of fixation devices is necessary, that hold the fragments in position, while the fracture heals.
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. However, 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.
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, 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. Besides, in the event that the bone breakage has been caused by stress or indirect trauma, the MRI will allow an evaluation of the knee joint to evaluate other possible ligament or meniscus injuries.
A knee fracture is a type of injury that involves the kneecap or the bone that makes up the front of the knee. (also known as patella). It can be as mild as a small partial crack in the bone or as severe as a complete tear from the top of the kneecap to the bottom.
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, as:
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:
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:
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..
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.
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
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.
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. However, with some fractures, weight bearing is not allowed during 6 a 8 weeks. Your doctor will discuss weight bearing restrictions with you..
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.
However, 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.
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..
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