Nonsurgical Treatment of Patella Fractures

The patella is the small bone at the front of the knee which can be felt by running your hand over the knee.

Despite being small in size, it plays a huge role in the movement of the human body. It is primarily responsible for stretching the leg and bending the knee joint while walking, climbing the stairs, sitting down or standing up, etc. These fractures account only 1% of all fractures in adults.

Like other bones, the patella can also suffer from a fracture. This is because it shields the knee and acts as the initial point of impact for any trauma to the front of the knee. When there is a fracture on the patella, orthopedics has several ways of treating it. However, first, you need to understand the anatomy of the patella.

Anatomy of the patella
The knee joint is the junction where the thighbone (femur) meets the shinbone (tibia). These 2 bones are connected by various tendons and ligaments. They ensure lateral stability, while the patella allows the joint to bend and stretch with every knee movement. The particular tendons that surround the patella are the quadriceps tendon.

It connects the muscle from the thigh to the patella and the patellar tendons which connect the patella to the shinbone. When this muscle of the thigh contract, the force is transferred to the skin, this is with the support of the patella.

A fracture of the patella can occur in many ways, usually due to a direct trauma to the knee joint, often resulting in comminuted fractures. However, patellar fractures can result from indirect mechanisms of injury, typically resulting in transverse fractures.

There are also different ways of taking care of this fracture, some surgical and others non-surgical. It’s always preferable to go for the non-surgical measures because there is less damage to the knee that would have been done by the surgical operation.

However, non-surgical interventions can only be done for patella fractures. And only when there is no damage to the quadriceps tendon and the patella is not displaced.If the patella is displaced it means that it has broken into several pieces and that it is impossible to solve this damage with conservative treatment.

Treating patella fractures without surgery
The goal of the treatment in cases of patella fractures is to restore the function of the extensor mechanism.

This is to minimize the loss of the patella bone, to maximize articular congruity and to allow early mobilization as soon as possible. As long as the fracture is minor, the patella is not displaced and there are no damages to the surrounding structures. This means that none – surgical treatment, also known as conservative treatment can be done.

The first step is to take the weight off the joint. This means resting the injured knee and leg for a while or using a wheelchair or crutches when walking. Since the patella supports the entire body weight, exerting pressure when it’s fractured can increase the damage and just make the situation worse.

To determine whether surgery is needed, imaging will be required in the form of X-rays which show the extent of the damage.

If the fracture does not require surgery, you might be advised to:• Have a knee brace or cast - Both braces and casts are supposed to keep the knee stationary and restrict movement so that the fracture can heal. This can take about 4 to 6 weeks for the healing to complete, but regular doctor visits should still be done for check-ups. The idea behind this measure is to let the fracture heal on its own without further pressure. It is only after the joint is almost healed and there’s no more pain upon bending the joint that physical therapy is done.

• Electronic bone stimulation - This is a process involving stimulation of proteins around the site of the injury using electricity. It is done by placing electrodes on the skin that transmit low electrical current to the joint. It’s for the stimulation that stimulates the healing process.

• Medications - Medications will be prescribed to help reduce the pain and inflammation. It will also help the healing of the fractured patella and its full recovery in the shortest time possible.