What is a knee fracture?

A knee fracture is a break in one of the knee bones. There are many types of fractures:

• Comminuted fracture: there are more than two bone fragments at the fracture.

• Compound (open) fracture: one end of the broken bone has broken through the skin.

• Closed fracture: neither end of the broken bone has pierced the skin.

• Compression fracture: the bone has broken from extreme pressure and has been smashed.

• Impacted fracture: the ends of the broken bone are driven into each other.

• Avulsion fracture: the muscle has pulled a portion of the bone away from where it was originally attached.

• Pathological fracture: the bone has been weakened or destroyed by disease so that the already weakened bone breaks easily.

How does it occur?

Knee fractures can occur in many ways: falls, contact sports and exercise injuries, force from a blow, and trauma.

What are the symptoms?

Symptoms of a knee fracture include:

• pain

• tenderness

• swelling

• limited range of motion

• pain made worse by movement

• grating of bone ends

• muscle spasm during slight movement

• physical deformity

• inability to walk.

How is it diagnosed?

To diagnose a knee fracture, the doctor will review your injury and symptoms. Because knee pain occurs in many disorders besides knee fractures, the doctor will thoroughly examine you to determine the cause of your pain. If the doctor suspects a fracture, he or she may order x-rays and stress films.

How it is treated?

The treatment depends on what bone is broken and what kind of fracture you have. If the bone pieces are lined up well, surgery may not be necessary and your knee may be set in a splint or cast.

If the fracture involves the patella (kneecap), the doctor may perform surgery to:

• remove all small fragments

• wire the kneecap fragments together if possible.

• remove a shattered patella.

If the fracture does not involve the kneecap, but rather the lower end of the thigh bone or upper end of the big lower leg bone, the doctor will manipulate the broken bone into the correct place. This is done most easily immediately after the injury, so prompt medical attention is necessary. The doctor may need to perform surgery. He or she may use metal pins, screws, or plates to hold pieces of bone together. This surgery is called internal fixation.

After surgery the doctor may put your knee in a cast. He or she will place the cast around the injured area to immobilize the joint above and below the fracture site.

You will learn how to care for your cast:

• how to elevate it on pillows

• how to bathe with a cast

• how to use crutches or a cane

• how to care for the skin around the cast edges.

Immobilization of a body part can cause joints to stiffen and muscles to weaken in uninjured areas. You will learn range-of-motion exercises to keep the uninjured parts healthy. You will also learn isometric exercises to strengthen the fractured part. Isometric exercises avoid movement. You create tension by contracting the muscle, holding the tension, and then releasing it without moving the joint.

How long will the effects last?

Healing times depend on which bone was broken, the type of fracture, the type of treatment, and how well you heal.

How can I take care of myself?

To help take care of yourself, follow the full course of treatment your doctor prescribes. Also, follow these guidelines:

• Eat a variety of nutritious foods.

• Get plenty of rest.

• Elevate the leg when possible to reduce swelling.

Call the doctor immediately if any of these symptoms appear:

• unusual warmth, redness, or swelling above or below the fracture

• discoloration: your toenails or feet become and stay blue or grey even though you are keeping your leg elevated

• numbness or complete loss of feeling in the skin below the fracture.

What can be done to help prevent knee fracture?

To help prevent a knee fracture, follow these guidelines:

• Wear proper, correctly fitting shoes when you exercise.

• Gently stretch before and after physical activity like aerobics, running, and sports.

• Work and play safely.