Patella Fracture
The patella, also known as the kneecap, is the largest sesamoid bone (a type of bone located inside a tendon) in the human body and also has the thickest cartilage, reaching up to 7 millimeters. The patella acts as a pulley, helping the muscles responsible for extending the knee to perform movements. Patellar fractures account for approximately 1% of all bone injuries in the body, with traffic accidents and falls being the most common causes.
When a doctor suspects a patellar fracture, a careful physical examination should be performed. One of the most important aspects is the patient's ability to extend the knee, as this can influence the treatment of the fracture.
Treatment
For fractures with minimal displacement between the fragments, in which the patient's ability to extend the knee is preserved, non-operative treatment can be performed. This type of treatment is based on immobilizing the knee with a brace (velcro immobilizer) or plaster cast for approximately 6 weeks. The patient can support the affected limb on the ground to walk as tolerated by the patient. In these cases, we recommend performing isometric exercises for the quadriceps muscle of the thigh (elevating the limb with the immobilizer) from the second week of treatment, so that the loss of muscle strength is reduced. When the physical examination performed on the patient and the radiographic exams show significant progress in bone healing, the immobilizer is removed and physiotherapy is started, with the aim of restoring the range of motion of the knee and gaining muscle strength.
In other situations, treatment must be operative. There are several surgical techniques that can be performed to treat patellar fractures, depending mainly on the type of fracture. Therefore, each case must be carefully evaluated by the doctor so that the best treatment can be indicated.
