A fracture is a condition in which there is break in the continuity of the bone. In younger individuals, these fractures are caused from high energy injuries, as from a motor vehicle accident. In older people the most common cause is weak and fragile bone.
Fractures of the knee can include the following:
Diagnosis is made through your medical history, physical examination, and other diagnostic imaging tests. X-rays are taken to know whether the bone is intact or broken. X-rays are also helpful to know the type and location of fracture. Your doctor may also recommend a computerized tomography (CT) scan to know the severity of fracture.
Treatment options include non-surgical and surgical. Non-surgical treatment involves skeletal traction and use of casts and braces. Skeletal traction involves placement of pin into the bone in order to realign broken bones. Surgery involves internal fixation and external fixation.
During the procedure, metal pins or screws are inserted into the middle of the femur and tibia and are attached to a device outside the skin to hold bone fragments in place to allow alignment and healing. If your bone is fractured in many pieces, a plate or rod is fixed at both ends of the fracture to maintain the overall shape and length of the bone in place while it heals. In elder patients where fracture healing delays, a bone graft taken from the patient or tissue bank may be used to form callous. In severe case, the bone fragments are removed and the bone is replaced with a knee replacement implant.
The most common complications of surgery include infection, knee stiffness, delayed bone healing, and knee arthritis.
Patella (knee cap) is a protective bone attached to the quadriceps muscles of the thigh by quadriceps tendon. Patella attaches with the femur bone and forms a patellofemoral joint. Patella is protected by a ligament which secures the kneecap from gliding out and is called as medial patellofemoral ligament (MPFL).
Dislocation of the patella occurs when the patella moves out of the patellofemoral groove, (called as trochlea) onto a bony head of the femur. If the knee cap partially comes out of the groove, it is called as subluxation and if the kneecap completely comes out, it is called as dislocation (luxation). Patella dislocation is commonly observed in young athletes between 15 and 20 years and commonly affects women because of the wider pelvis creates lateral pull on the patella.
Some of the causes for patellar dislocation include direct blow or trauma, twisting of the knee while changing the direction, muscle contraction, and congenital defects. It also occurs when the MPFL is torn. The common symptoms include pain, tenderness, swelling around the knee joint, restricted movement of the knee, numbness below the knee, and discoloration of the area where the injury has occurred.
Your doctor will examine your knee and suggests diagnostic tests such as X-ray, CT scan, and MRI scan to confirm condition and provide treatment. There are non-surgical and surgical ways of treating patellofemoral dislocation.
Non-surgical or conservative treatment includes:
Surgical treatment is recommended for those individuals who have recurrent patella dislocation. Some of the surgical options include:
After the surgery, your doctor will suggest you to use crutches for few weeks, prescribe medications to control pain and swelling, and recommend physical therapy which will help you to return to your sports activities at the earliest.
Click on the topics below to find out more from the orthopaedic connection website of American Academy of Orthopaedic Surgeons.