How is a patellar fracture treated without surgery?
If the pieces of bone are not out of place (displaced), you may not need surgery. Your doctor may apply a cast or splint to keep your knee straight and help prevent motion in your leg. This will keep the broken ends of bone in proper position while they heal.
Depending upon your specific fracture, you may be allowed to bear weight on your leg while wearing a cast or brace. With some fractures, however, weight bearing is not allowed for 6 to 8 weeks. Your doctor will talk with you about restrictions on weight bearing.
How is a patellar fracture treated with surgery?
The type of procedure performed depends on the type of fracture you have. Before the surgery, your doctor will discuss your procedure with you, as well as any potential complications.
These two-part fractures are most often fixed in place using screws or pins and wires and a "figure-of-eight" configuration tension band. The figure-of-eight band presses the two pieces together. This procedure is best for treating fractures that are located near the center of the patella. Fracture pieces at the ends of the kneecap are too small for this procedure. Breaks that are in many pieces can be over compressed by the tension band.
Another approach to a transverse fracture is to secure the bones using small screws or small screws and small plates.
In some fractures, the top or, more likely, the bottom of the patella is broken into several small pieces. This type of fracture occurs when the kneecap is first pulled apart from the injury, and is then crushed when the patient falls on it.
Because the bone fragments are too small to be fixed back into place, your doctor will remove them. He or she will then attach the loose patellar tendon back to the remaining patellar bone.
If the kneecap is broken in many pieces at its center and the pieces are separated, your doctor may use a combination of wires and screws to fix it. Removing small portions of the kneecap that cannot be reconstructed may also have good results. Complete removal of the kneecap is a last resort in treating a comminuted fracture.
What is recovery like after a patellar fracture?
Whether your treatment is surgical or nonsurgical, rehabilitation will play a vital role in getting you back to your daily activities. Because treatment for a patellar fracture can sometimes require keeping your leg in a cast so that you are unable to move it for a long period of time, your knee may become stiff and your thigh muscles may become weak.
During rehabilitation, your doctor or a physical therapist will provide you with specific exercises to help:
- Improve range of motion in your knee
- Strengthen your leg muscles
- Decrease stiffness
Your doctor will tell you when you can begin to bear weight on your leg. Initial weight-bearing exercise is usually limited to gently touching your toe to the floor. As your injury heals and your muscles strengthen, you will gradually be able to put more weight on your leg.
How long does it take to recover from a patellar fracture?
This will depend upon a number of factors, including:
- The severity of your injury
- Whether your treatment was surgical or nonsurgical
- The time needed for rehabilitation
Most patients will be able to return to their normal activities within 3 to 6 months. For patients with severe fractures recovery may take longer
Your doctor may suggest some lifestyle changes to help protect your knee and prevent future problems. This may include avoiding activities that involve repetitive deep knee bending or squatting. Climbing stairs or ladders should be avoided, as well.