Knee > Fractured Kneecap

What is the Kneecap?

The kneecap, also known as the patella, is a triangular bone, situated at the front of the knee. There are several tendons and ligaments connected to the kneecap, including those attached to the upper leg (femur) and lower leg (tibia) bones. Though the kneecap is not necessary for walking and bending your leg, it increases muscle efficiency and absorbs a considerable amount of the stress placed between the upper and lower portions of the leg. Climbing stairs and squatting can put up to seven times your normal body weight on the kneecap and the joint behind it.

The kneecap can either be partially or completely broken into a few or many pieces in many different configurations. Fractures may be accompanied by a sprain or rupture of the ligaments or tendons attached to the kneecap.

In most cases, a direct blow to the front of the knee will be the cause of a fractured kneecap. This can happen while playing contact sports, but in many cases it occurs in a more violent collision, such as an automobile accident. Kneecap fractures account for about one percent of all skeletal injuries, with the majority of fractures suffered by people between the ages of 20 and 50.

There usually are three parts to an orthopedic evaluation: medical history, a physical examination, and tests that your physician may order.

Your doctor will likely ask you how you injured your knee, how it has been feeling since the injury, and if your knee has been previously injured. Physicians also typically ask if you have any other medical conditions, have had prior surgery, are taking any medications, or have any allergies to medications. The doctor may also ask about your physical and athletic goals - ­ information that will help him decide what treatment might be best for you in achieving those goals.

A physician can often diagnose a fractured kneecap by asking you about the details of your accident and examining you. Your physician will examine your knee and focus on areas of tenderness, swelling, and deformity. Your physician will also ask you to raise your leg and/or extend your knee, possibly after giving you a local anesthetic to eliminate pain, to help determine whether there may be additional injuries in and around your knee.

TESTS

X-rays, taken from several angles, are the best way to determine the extent of a fractured kneecap and to screen for additional injuries. If other injuries are suspected, a CT (computer tomography) or MRI (magnetic resonance imaging) scan may be obtained. A CT scan, commonly referred to as a CAT scan, provides finer details of the fracture. An MRI scan can provides finer details of soft tissue (i.e. muscle, ligament, tendon, and meniscus) structures.

   Imaging techniques