Patient education: Patella fracture (The Basics)

What is a patella fracture? — A "fracture" is another word for a broken bone. The patella, or "kneecap," is part of the knee joint (figure 1).

There are different types of fractures, depending on how the bone breaks. When a bone breaks, it might crack, break all of the way through, or shatter.

If a broken bone sticks out of the skin or can be seen through a wound, doctors call it an "open" fracture. If the bone does not stick out of the skin or cannot be seen through a wound, doctors call it a "closed" fracture.

A patella fracture can happen because of:

●A sports injury or other accident

●Falling on the knee

●A direct blow to the patella

What are the symptoms of a patella fracture? — Common symptoms include:

●Pain, swelling, or bruising over the area

●Trouble bending and straightening the knee normally

●Not being able to put weight on the injured leg

Is there a test for a patella fracture? — Yes. The doctor or nurse will ask about your symptoms, do an exam, and take an X-ray.

They might also do other imaging tests, such as a CT, MRI, or ultrasound. Imaging tests create pictures of the inside of the body.

How are patella fractures treated? — Treatment depends, in part, on the type of fracture and how serious it is. The goal is to have the pieces of broken bone line up with each other so the bone can heal.

If the pieces of broken bone are already in line with each other, the doctor will put on a cast, splint, or brace. This will keep the bone in the correct position so it can heal and will limit bending the knee.

If the pieces of broken bone are not in line with each other, the doctor will need to line them up:

●Sometimes, they can move the bone to the correct position without doing surgery, and then put a cast, splint, or brace on. This is called "closed fracture reduction."

●For more serious fractures, they might need to do surgery to put the bone back in the correct position. During surgery, they can use screws, pins, wires, or plates to fix the bone inside the body. This is called "open fracture reduction."

How long do patella fractures take to heal? — Most patella fractures take weeks to months to heal. The doctor or nurse will talk to you about when to return to things like work, sports, or other activities.

Healing time also depends on the person. Healthy children usually heal much more quickly than older adults or adults with other medical problems.

How do I care for myself at home? — To care for yourself or your child at home:

●Follow the doctor's instructions for wearing the splint, brace, or cast. This supports and protects the bone as it heals. Some fractures are placed in a cast right away. Others are not put in a cast until after the swelling goes down.

●Do not get a cast wet unless the doctor that says it is waterproof.

●Follow instructions for limiting activity and movement until the bone is healed. The doctor or nurse will tell you what activities are safe to do.

●Prop the injured leg on pillows, keeping it above the level of the heart. This might help lessen pain and swelling.

●The doctor might recommend an over-the-counter pain medicine. These include acetaminophen (sample brand name: Tylenol), and ibuprofen (sample brand names: Advil, Motrin). Adults can also take naproxen (sample brand name: Aleve).

●Some people get a prescription for stronger pain medicines to take for a short time. Follow the instructions for taking these.

●Ice can help with pain and swelling:

•Put a cold gel pack, bag of ice, or bag of frozen vegetables on the injured area every 1 to 2 hours, for 15 minutes each time. Put a thin towel between the ice (or other cold object) and the skin.

•Use the ice (or other cold object) for at least 6 hours after the injury. Some people find it helpful to ice longer, even up to 2 days after their injury.

●Eat a healthy diet that includes plenty of calcium, vitamin D, and protein (figure 2).

●If you smoke, try to stop. Broken bones take longer to heal if you smoke.

●Some people need to work with a physical therapist (exercise expert) after their fracture heals. The physical therapist will suggest exercises and stretches to strengthen the leg muscles and keep them from getting stiff. The exercises will work on bending and straightening the knee fully.

When should I call the doctor? — Call for emergency help right away (in the US and Canada, call 9-1-1) if:

●You feel short of breath or have trouble breathing.

●You have sharp or severe chest pain when you breathe.

●You are coughing up blood.

Call the doctor or nurse for advice if:

●There is less feeling or movement in your toes or foot.

●Your knee or leg becomes more swollen or starts to hurt more.

●Your skin becomes red or irritated around the cast, or redness starts to spread up your leg.

●The splint or cast feels too tight and uncomfortable, or your toes turn pale, blue, or gray.

●There is a bad smell or drainage coming from the splint or cast.

●The cast feels too loose, you notice a crack in the cast, or the cast becomes soft.

●The cast gets wet, and it is not supposed to get wet.

More on this topic

Patient education: Fractures (The Basics)
Patient education: Setting a broken bone in adults (The Basics)
Patient education: Setting a broken bone in children (The Basics)
Patient education: Surgery to fix a broken bone (The Basics)
Patient education: How to care for your cast (The Basics)
Patient education: How to care for your child's cast (The Basics)
Patient education: How to care for a splint (The Basics)

Patient education: Cast and splint care (Beyond the Basics)