Patella (“kneecap”) fractures are relatively common and typically occur following a fall directly onto the knee. Your patella is a “sesamoid” bone meaning that it is found within a tendon, in this case the quadriceps tendon. The patella is vitally important to normal quadriceps function and hence fractures can be terribly debilitating. Some people are born with what is known as a “bipartite” patella as a result of failure of normal ossification during development. These patients are functionally normal but it is important to differentiate these patients from those with an acute fracture.
Patients with patella fractures are typically assessed initially by a physician in the emergency department. Occasionally, patients with patella fractures may present with “open” injuries meaning that the fractured bone is open to the environment. In this case, it is important to administer IV antibiotics and ensure your tetanus prophylaxis is up to date as soon as possible. Once the diagnosis of a patella fracture has been made, you will be assessed by an orthopaedic surgeon to decide on the best course of treatment going forward. Broadly speaking, there are two options for treatment:
- Non-Operative Treatment: There are certain situations in which it may be appropriate to treat your patella fracture without surgery. If your fracture has shifted only minimally and you are able to extend your injured knee, you can likely be treated with a functional brace.