The patella is the largest sesamoid bone in the human body. It is woven into the tendon of the quadriceps femoris muscle, thereby increasing its strength and participating in the extensor mechanism of the knee. Its location in the front of the knee makes it vulnerable to injury. Trauma affecting the anatomical integrity of the knee cap is called a patella fracture. Its incidence is about one percent compared to other skeletal fractures. Its involvement functionally affects the limb and leads to difficulties in carrying out activities of daily life. Therapeutic measures act in this direction by improving the structure and hence the function.
Clinical picture of patella fracture
A traumatic event with a direct blow to the patella with the knee joint in flexion is the most common mechanism of patellar fracture. Depending on the intensity of the trauma, there are: transverse, vertical, oblique, comminuted and other types of fractures. This is visualized by X-ray. It also provides information about the state of the patellofemoral joint. The clinical picture is associated with pain, hemarthrosis, abrasion, impaired integrity / in case of displaced fractures/. The knee joint is functionally affected in terms of the extensor mechanism. The support function is impaired.
Patella fracture treatment
A patella fracture can be repaired conservatively or surgically. This depends on the type of fracture. A non-displaced fracture or one located in the lower part of the patella with preserved extensor mechanism and retinal integrity can be treated conservatively. Treatment consists of six weeks of immobilization and vertical weight-bearing of the limb until union, followed by physical therapy and rehabilitation. An operative approach is indicated for displaced, comminuted or open fractures of the knee cap. Their goal is to restore the anatomical integrity of the bone and joint surface. Followed by immobilization with a straight splint and rehabilitation.
Physiotherapy and kinesitherapy
The exercise period begins after permission from the attending physician. Regardless of the treatment approach, physical therapy and kinesitherapy occupy an important place in the recovery process. With their help, the affected knee extensor mechanism, the volume of movement in the joint and the muscle strength are restored. Bipedal gait is gradually restored by removing the crutches followed by the splint. The program of therapeutic exercises, prepared by a specialist kinesitherapist, unfolds gradually until full functional restoration of the joint and the limb respectively.
