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..
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.
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
Incluso después de un tratamiento exitoso, algunos pacientes con fracturas rotulianas pueden experimentar complicaciones a largo plazo.
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.
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.
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.
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.
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:
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
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.
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.
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.
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:
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, como:
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, por otro lado, 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..
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.
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. Nevertheless, 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.
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.
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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