Fracture of patella: treatment and consequences

Fracture of patella: treatment, consequences, rehabilitation

With a patella fracture, the integrity of the flat, round bone located above the knee joint is compromised. The human knee is the most complex combination of the musculoskeletal system.

Due to his functions, a person is able to perform various actions - walking, sitting down, running.

It is not surprising that after a fracture of the patella, a man for some time falls out of the rut because of the inability to perform such seemingly simple and familiar actions as ordinary walking and run.

The component parts of the knee joint are the fibular bone, the tibia, the hip bone and the knee cap itself. Its name was given to the bone of the joint due to its peculiar form.

The base of the patella is wide and has rounded edges. The apex of the calyx has an elongated and pointed form on the end.

Complete ossification of the patella occurs about five years, until the age of two she completely consists of cartilaginous tissue. This part of the joint can be easily probed through the skin and shifted to the sides when the knee is in the straightened state.

Patella function and injury mechanism

Fracture of the kneecap is a very dangerous injury, as the patella performs the protective function of the femur and tibia from lateral displacement.

During flexion and extension of the limb, he makes movements up and down. In addition, this part of the knee increases the effectiveness of muscle tissue.

Also, the patella protects the joint from various injuries - it takes a hit on itself.

When there is a trauma to the patella, bone changes occur. Muscular force pulls the bone fragments in different directions, while the integrity of the joint capsule, ligaments and cartilaginous tissue is impaired.

The consequences of this trauma can be very severe, so after a patella fracture, it is necessary to contact the doctor as soon as possible for examination and further treatment.

Causes

Fracture of the knee is more often diagnosed in male patients in middle age.

This injury is most often due to a very direct knee stroke.

In the risk zone are those who are actively involved in sports, as well as older people who have osteoporosis. The main traumatic causes are:

• falling from a certain height to the leg, bent at the knee joint;
• road accidents;
• a blow to the knee with something heavy;
• a strong and sudden contraction of the muscle tissue near the calyx.

You can break a knee in a domestic setting, at work, during a fight, or a criminal attack, as well as in other unforeseen situations.

Classification

Trauma can be complete or incomplete, and also be of an indoor or outdoor nature. The fracture line can run parallel to the axis of the cup, or perpendicular to it.

Also, a marginal type of injury is possible, in which the lower part of the patella is detached. If the fracture is incomplete, a crack appears in the patella.

In addition, the damage varies in nature:

1. Fracture of the patella with displacement occurs when, at the time of injury, bone fragments are separated from each other due to the tension of muscles and ligaments;
2. Fracture of the patella without displacement proceeds with tightly adhered to each other bone fragments;
3. Trauma of a comminuted type is characterized by the presence of many small fragments of broken bone.

The timing of treatment, as well as the recovery period, directly depend on the type of fracture. Damage without displacement of fragments is considered to be the easiest, after which a person restores for a short period.

In injuries with displacement there are various complications, for the treatment of which more time is needed. Splinter damage is the heaviest.

Their treatment is impossible without surgical intervention, and the recovery period is long and requires a serious approach from the patient.

Symptomatology

In people with knee injury, the following symptoms occur:

• severe swelling of soft tissues in the area of ​​trauma;
• sharp painful sensations, amplifying during palpation and attempts of movements;
• crepitation of bone fragments;
• hemorrhage into the joint cavity (hemarthrosis);
• impaired motor function of the joint;
• if there is no bias, then the victim can move, but at the same time he feels an increase in pain;
• a gap between fragments of bones is felt;
• pathological mobility in the place of injury;
• deformation of the joint;
• hematoma, gradually descending to the popliteal cavity.

If there are signs that indicate a kneecap injury, you need to give the person first aid and transport him to a medical facility.

First Aid

First aid includes a few simple steps. Even for a person who is not particularly familiar with medicine, it will not be difficult to help the victim if you drop the panic and know some moments of help with a fracture of the calyx:

1. put a person on a hard surface;
2. when an open fracture should be applied a tourniquet from a suitable thing (tissue, rope, rubber) to the area slightly above the injury, remembering the time of application;
3. immobilize the limb with a tire in the position it took at the time of the fracture;
4. give the victim an anesthetic drug to prevent traumatic shock;
5. call a team of doctors, or deliver the victim to a trauma center on his own.

Diagnosis - external examination of the injury

During the diagnosis, the doctor conducts an external examination of the site of the injury and palpation. After this, the patient is referred for radiology.

In the picture, the doctor sees a gap between the bone fragments, which helps to distinguish this type of damage from rupture of the knee ligament apparatus, from rupture of tendons and traumatic arthritis.

Complaints of the patient for pain indicate that it was a fracture, and not a congenital anomaly of a separate patella.

During such congenital abnormalities, the cleft is present immediately in both joints and is not accompanied by pain syndrome.

Next, you should make a computer tomography with which you can assess the condition of ligaments, muscle tissue, vessels, nerve endings and the joint capsule.

Healing measures

Treatment of patella fractures depends on the nature of the lesion and the presence of displacement fragments. If the fracture is stable, then displacement is not observed and is not expected, with an unstable type of injury there is a shift, or there is a risk of its occurrence.

Conservative treatment

If the fracture is stable, doctors prescribe treatment with the help of a conservative method.

First, the doctor conducts anesthesia of the injury site, then the knee joint is punctured, since too much blood accumulates in the joint capsule.

The patient's limb is straightened, after which a plaster bandage is applied. Immobilization begins with the upper part of the femur and ends with an ankle.

The effectiveness of treatment and the process of consolidation is observed using a periodic radiograph.

After removal of the plaster of the patient, rehabilitation after a fracture is expected, which is aimed at restoring the strength of muscle tissue and the amplitude of movements.

With a conservative method of treatment, the joint is immobile for a long time, so it will be quite difficult for him to regain his former mobility.

In addition, during the course of conservative therapy, the patella may not grow properly, which in the future often causes a disruption in the functionality of the knee, as well as gonarthrosis or osteoporosis.

Surgical method of treatment

If the bone fragments are displaced more than two millimeters, the doctor performs an operation to compare the fragments, restore the joint surface and fix the fragments.

Parts of the knee cap are fastened with knitting needles, bolts, screeds or wire. With splintered injuries, the doctor sews up large fragments with a lavsan cord, and removes small ones.

After the operation, gypsum is applied for the same period as for conservative treatment.

Many patients are wondering whether it is possible to walk with a gypsum superimposed on the limb. It is possible, but only after the doctor assesses the general condition of the patient.

In this case, the load on the leg should be minimal and gradually increase.

A source: https://VseoTravmah.ru/perelomy/perelom-nadkolennika.html

Causes and treatment of a patella fracture (patella)

The largest sesamoid bone represented in the form of flat roundness is the patella. It is inherent in him to protect the femoral and tibia from dislocations.

Also, the patella strengthens the power of the muscles, thereby contributing to hanging the effectiveness of their work.

Fracture of the patella occurs rarely, as this joint is famous for its strength and it can only be damaged by provoking a very strong direct stroke.

Causes

According to statistics, the fracture of the knee joint most often occurs in men and people who are engaged in various types of extreme sports. It appears with a very strong direct impact in the area of ​​the patella. Also, trauma can be obtained because:

• falling on the knee area with a great speed and height;
• road accident;
• a blunt or sharp object in the knee;
• a sharp contraction of the muscles that attach to the knee bone.

Symptoms

As in the case of other injuries, with a patellar fracture, there are also the first symptoms:

1. severe pain that occurs immediately after getting injured;
2. over time, the pain does not stop, but only turns into a dull and aching;
3. when trying to move a limb damaged by a limb, the pain is greatly increased;
4. there is a deformation of the knee joint area, the bone becomes very mobile, and the person feels a vibration in it;
5. quickly begins to swell the knee and it appears edema and bruises;
6. there is a feeling that the knee is bursting from the inside, this is due to the accumulation of blood inside the joint;
7. if the ligaments are not damaged in the fracture, the victim will be able to walk, but he can do this only with a straight leg, because it will be impossible to bend it because of acute pain.

A Variety of Fractures

There are several types of patella damage:

• fracture without bias - this kind is considered the most harmless, the period of treatment passes quickly and without complications;
• fracture of patella with displacement - this type of injury in some cases is accompanied by damage to muscles and blood vessels. Often the appearance of such a fracture requires surgical intervention;
• A comminuted fracture is the most dangerous type of injury, after which complications often occur. Treatment of such bruises is carried out with the use of osteosynthesis, and if it does not help, then with the help of surgery they remove the fragments and sometimes completely replace the bone with a prosthesis;
• open and closed fractures. When the fracture is open, soft tissues, muscles and blood vessels suffer.

Diagnostics

A qualified doctor initially asks the injured person the reasons for the occurrence of this injury.

Then an X-ray is taken, thanks to which the doctor makes a conclusion about the degree of severity and the type of injury received. Sometimes you may need a detailed diagnosis with MRI.

In order to check the blood content inside the joint, the puncture procedure is performed.

The first necessary help in case of injury

If the injured person feels severe pain, then, first of all, you need to give him any pain medication.

Then you need to fix the injured limb in one position, you can do it with any help items, most importantly, to fit the size and strength of the material used. The tire is applied from the beginning of the shin and up to the thigh.

If there is a strong edema or deformation of the bone, do not try to press or direct the bones yourself, you need to provide the patient with specialist help in the shortest possible time.

How to treat knee cap fractures

Treat such injuries in two ways: operative and conservative. Choose which method is more suitable for you, should an experienced doctor, based on the results of your survey.

Conservative method is used for damage of light gravity. To begin with, the doctor uses an anesthetic. If a joint is found in the joint, there is a puncture.

If a fracture is observed in the fracture, then the doctor must closely compare fragments of fragments. After the procedure, the bone is fixed by applying a gypsum from the hip to the ankle.

The period of limb immobilization is from four to six weeks. After the removal of the gypsum, the necessary procedures for restoring the leg will be prescribed.

The consequence of conservative therapy may be improper bone fusion, the occurrence of gonarthrosis and osteoarthritis of the patella.

The operative method is used when the fragments are displaced.

During the surgical intervention, doctors compare the displaced fragments, normalize the condition joints and fix the knee joint, using for this purpose metal spokes, plates and special wire.

And if the fracture is also of a comminuted type, during the operation the surgeons also remove small pieces of bone. After the operation, the patient is also impose a plaster to immobilize the injured limb.

Rehabilitation after fracture

Rehabilitation after a patella fracture is no less important than the process of the treatment itself.

On how seriously you will treat it, the result of recovery and the ability to move freely depends.

For this purpose, the doctor appoints special massage courses, exercise therapy and a set of specific exercises. Even during the wearing of gypsum, it is necessary to wiggle your toes to prevent the possible appearance of blood clots. With the correct approach to rehabilitation procedures, the risk of complications is minimized.

Possible complications

As with other injuries, after a fracture of the knee joint, sad consequences can also arise:

• muscle atrophy - when it occurs, a person loses the ability to move freely;
• can develop arthritis due to damage to cartilaginous tissues;
• bones do not fuse properly;
• there is chronic pain in the injured area;
• gonarthrosis or osteoarthrosis of the knee;
• the elasticity of the ligaments is disturbed.

A source: https://PerelomaNet.ru/perelomy/povrezhdenie-nadkolennika.html

Fracture of patellar period of recovery and rehabilitation

To traumatize a patella, called in the people by the kneecap, will not be very difficult. However, fractures of this area are not so common. The bone is quite strong and it can be damaged only by applying a large acting force.

Anatomical reference

The patella is a small rounded bone. It is called sesamoid, that is located inside the tendons, as they hold the knee cap on all sides.

It is attached to the femoral quadriceps muscle. One of the main functions of the patella is to increase the effectiveness of muscle traction and strength.

In addition, it protects the knee joint from damage, it is a kind of shield, and does not allow the bones to move sideways.

The inside is covered with cartilage, which makes it very smooth, and snug against the bone of the thigh. The outer part is convex and quite rough, as it is covered with the periosteum. It is all dotted with holes through which blood vessels pass.

A characteristic feature of this part of the body is that in children before reaching the age of two, the patella is a cartilage that begins to bite after five years. It can be easily probed through the skin. When the leg is in the unfolded state, the cup freely moves to either side.

Causes of injuries

Unfortunately, protecting the joint from external influence, the patella suffer first of all. To damage it is not so difficult. The most common causes of patellar fractures include the following:

1. road accidents;
2. sports injuries;
3. falling from a considerable height to a bent knee;
4. actions leading to a sharp reduction of the muscles attached to the calyx;
5. a strong blow to the patella area.

Such traumas affect young people and people of middle age. And men treat her more often than women. The risk group includes elderly people, especially those who suffer from osteoporosis.

Classification of injuries

Based on the fact that it was the cause of the injury, which force affected the limb, fractures of varying severity are formed.

Less dangerous and complex is considered a patellar fracture without the displacement of bone fragments. The process of treating such damage is simple and almost always successful.

Most often, a patellar fracture with a displacement is diagnosed, which can be burdened by a joint disorder.

At the time of this injury, the bone fragments under the influence of the musculature diverge in different directions and damage the cartilage, ligaments and joint.

To eliminate it, as a rule, surgery is required, and the recovery process is complex and time-consuming.

Also, open and closed patellar fractures are distinguished, and not only the skin but also the tendons, ligaments and blood vessels can be damaged during the trauma.

The most complex and dangerous are the fractured fractures. To eliminate them, osteosynthesis is recommended, however, the probability is high that the method will not give a positive result.

Such a trauma often leads to the development of a number of complications.

In place of localization and character, fractures are:

• transverse (horizontal), in which the fracture line divides the bone into two transverse fragments;
• marginal: as a rule, the lower part of the bone breaks off;
• longitudinal (vertical), when the line of break passes along the cup;
• osteochondral, in which a small patch of the patella surface is detached;
• multi-lobed: the bone is fragmented into many fragments.

The most common fractures are horizontal. This is due to the attachment of the quadriceps muscle to the apex of the patella, which leads to the traction of the sesamoid bone upwards.

At the time of injury, the fragments diverge up and down under the force of this traction, forming a gap.

But the vertical fracture is rarely accompanied by the displacement of bone fragments, since the vector of the impact of muscle strength passes along the fracture line.

Symptomatology of pathology

Like any other, a patellar fracture is accompanied by a number of characteristic symptoms:

1. Painful sensations in the affected area. They become much stronger if they attempt to stand on the injured leg, as well as during palpation.
2. Disturbances of motor function. Quite often the victim can not unbend the affected limb: attempts to raise it are accompanied by sharp pain.
3. Swelling of the affected limb. Trauma refers to intraarticular and, like any other, is accompanied by internal bleeding (due to damage to blood vessels). This leads to the accumulation of blood in the joint cavity (hemarthrosis) and the swelling of the lesion. The patient is impaired motor function, and there is a feeling of bursting. At the site of the trauma, an extensive hematoma forms, which after a while will start to fall into the area of ​​the foot.
4. Deformation. External changes can be not only the patella, but also the knee joint as a whole. In this case, the fracture is easily determined even after visual examination.

There may be crepitus (crunch on palpation) or unnatural mobility in the affected area.

Diagnosis of a traumatologist

Only the traumatologist can perform an accurate diagnosis after the examination of the patient.

First, a visual examination and palpation are performed, an anamnesis is collected, indicating the main complaints of the victim, the mechanism of injury.

However, a 100% guarantee of correct diagnosis can only be given by radiographic examination performed in three planes:

• a direct projection visualizes the intraarticular trauma of the internal or external condyles;
• the lateral projection provides an opportunity to see fractures of the transverse nature and condition of the condyles;
• Axial projection shows vertical and osteochondral lesions.

As a sample, a picture of a healthy knee is made, and in case of controversy, magnetic resonance imaging and computed tomography can additionally be prescribed. Puncture is performed to reveal blood in the joint cavity.

If there is a wound at the injury site, the following procedure is used to diagnose a penetrating and open fracture.

A sterile needle draws blood from the affected joint, and injects into its place fifty milliliters of sterile saline.

If the solution flows through the wound, then an open fracture is confirmed.

Recovery process

After the diagnosis the attending physician prescribes therapy: conservative or operative. The choice is due to the severity and type of injury received.

If there was a fracture without displacement of bone fragments, then the victim is removed from the knee joint blood, put on the skin antiseptic and, straightening the leg, fix it with gypsum.

Before this, a bandage is put on the knee cap. Gypsum is applied from the hip to the ankle, grasping the entire surface of the affected limb.

Sometimes the leg is fixed in the attached position.

On the fourth day of treatment, UHF is prescribed, and in a week you can perform therapeutic gymnastics. You can not lean on a damaged leg, you need to move using crutches.

During this period, several control X-ray studies are conducted, confirming the positive dynamics in the treatment. The cast is removed after a month or one and a half, the patient is allowed to stand on his foot.

But to relax still early, it is necessary to continue to be treated, performing a set of recommended physical exercises and visiting physiotherapy procedures.

Such a trauma is well treatable and is not often accompanied by negative consequences. However, in rare cases complications can occur (arthritis, ligaments lose their elasticity, gonarthrosis, muscle atrophy, persistent pain, improper fusion of fragments, osteoarthritis).

When fragments of a bone have dispersed more than on two millimeters from each other, to combine them in the closed way it is impossible.

With surgical intervention, all the broken parts are compared to their natural physiological state, and fixing with special devices (bolts, knitting needles, wire seam).

Muscular-tendinous plastic or Berger-Schultze operation can be performed. Multiple fracture fracture is fastened using lavsan thread.

Some of the small fragments are removed, if necessary, the whole patella is replaced with a prosthesis. After successful completion of the operation, immobilization with gypsum is carried out.

The bandage is removed after about two months, after which it can be prescribed wearing a removable langety.

During the treatment, medications are prescribed that help the body cope with the disease (antibiotics, anesthetics, analgesics, non-steroidal anti-inflammatory drugs). Drugs should be taken only on the advice of a doctor and under his supervision. Self-medication can cause a number of undesirable consequences.

Rehabilitation and recovery

The recovery process is more difficult for elderly patients. The level of calcium in their body is significantly reduced. Old people, along with traditional treatment, are recommended a special diet and supplements.

In the rehabilitation period, procedures are prescribed to help restore the motor function of the injured limb.

These include: electrophoresis, UHF, water therapy, magnetotherapy, medical massage, exercise therapy, paraffin therapy.

If the injury was difficult, a full recovery can take up to three months.

Timely treatment in the hospital, accurate diagnosis and adequate treatment will help to avoid negative consequences and to restore the normal functioning of the limb as soon as possible. Do not neglect the resulting injury or self-medicate. Neglect of your health can complicate your life in the future.

A source: https://TravmaOff.ru/perelom/nadkolennika.html

Fracture of the patella: symptoms, treatment, rehabilitation

Fracture of patellarefer to "street" injuries, that is, to those that can be obtained by falling on the street. This injury among other fractures accounts for up to 2% of the total number. The most exposed to her are men.

This is how the patellar fracture

Fracture of the kneecap

The patella is necessary for the person to protect the main knee joint, preventing the shift of the tibia and femur. Despite its protective function, it is quite easy to damage it when struck. For this it is enough to simply fall from the height of its growth.

Often a fracture is accompanied by an injury to the quadriceps muscle of the thigh and even a rupture of the tendons.

Sometimes the fragments can divorce quite severely, which makes it difficult to restore the integrity of the joint at the time of surgery.

First aid for the victim

If a fracture of the patella occurs, the limb is restricted in movement, and a cold compress is applied to the affected area.Anesthetic can be taken before a visit to the doctor.

Fracture of patella: symptoms

Fracture of patella symptoms is very obvious:

• the presence of gaps between the parts of the bone;
• edema;
• a crunch at palpation or excessive mobility of fragments;
• hemarthrosis;
• deformation in the area of ​​injury;
• strong pain.

With a fracture, a large hemorrhage is formed. If at the beginning of the bruise is found only on the knee, then after it is able to spread to the foot.

After the injury, it is difficult or impossible to bend the leg, although the ability to move is preserved, if there is no displacement.

In this case, the patient experiences severe pain during movement.

With a shift in the patellar fracture, the symptoms are more acute, walking is completely limited, it is difficult to raise the straightened limb.

Types of fracture

There is a fracture of the patella open (bone damages the dermis, muscles, the upper layer of the skin), closed, with displacement, without it and multi-lobed. In addition, the localization trauma is divided:

1. Transversal (horizontal). The most frequent fracture of this species. The fragments can travel a long distance, because the mechanical impact (impact) was sharp.
2. Osteochondral fracture is difficult to detect on the roentgenogram. In this case, part of the articular surface of the patella is detached, which is accompanied by a dislocation.
3. Vertical. The bone has a vertical fracture. There is a trauma similar to the transverse view of the fracture, but the impact is not so strong and sharp. Fragments with vertical damage usually does not happen.
4. The marginal fracture can be attributed to the subspecies of the vertical, since the mechanism of its appearance is the same, only the fracture line passes along the inner or outer part of the patella.
5. Splintered. More than 3 fragments are formed, therefore the trauma is considered the most difficult. Fragments are able to move both outward and inside the joint, but sometimes displacement does not occur.

Types of patellar fracture

Fracture of patella: treatment

The type of treatment is selected depending on which fracture of the kneecap occurred, whether the fragments of the bone have shifted.

Immobilization of the patella

Conservative treatment

Without bias, a patellar fracture (treatment is chosen strictly individually!) to treat begin with the introduction into the area of ​​trauma of analgesics.

After the patient has been delivered to the doctor, an examination will be carried out and the necessary diagnostic measures will be taken. They are required not only to determine the nature of the trauma, but also to detect the presence of blood in the joint.

So, if it is present, it will be necessary to perform a puncture, and only then to carry out treatment.

Immobilization is carried out to the ankle or to the hip, the leg itself is in the forward position. It remains immobilized for the next 4-6 weeks. During this period, periodically make painkillers injections, take multivitamins to maintain proper muscle nutrition.

If a patellar fracture occurs, the rehabilitation takes a longer period than the immobilization stage. It is important to follow the doctor's recommendations to prevent improper knee joint fusion and various complications (eg, synovitis of the knee joint).

Operative treatment

Surgical intervention is necessary if a significant bone displacement occurs. Fracture of the patella treatment in this case is similar to a partial rupture of the meniscus.

If the displacement itself is not eliminated, the integrity of the bone tissue will not be restored, which means that the motor activity of the knee will be severely limited.

In such cases, there is a risk of developing various complications, from knee gum to polyarthritis of the knee.

Partial patellectomy is appropriate in cases where the fracture does not affect the main articular surface. Then the fragment is removed, and the ligament of the knee is sutured.

After any surgical intervention through orthosis or gypsum, the limb is completely immobilized. The doctor determines the period of their wearing, based on the success of the operation and the speed of recovery of the patient.

Fracture of patella: rehabilitation

The exercise bike is good for rehabilitation in the last 1-2 months of the recovery course.

Control radiographs are done throughout the treatment and rehabilitation phase. In the first phase of recovery (2-4 days), you can not load a limb, and it is best to hang it or lay it on a soft roller.

Holding the leg above the body can prevent the occurrence of swelling in the knee area.

Throughout the first stage you need to move the foot and fingers as often as possible, as this helps to maintain the necessary mobility of muscles, and in addition also prevents dangerous vascular complications.

After a while, a small load on the injured leg will be allowed. Fracture of the patella (rehabilitation) has already passed into the recovery phase, so it is important to walk a little, step on the limb. You can rely on it before the onset of pain.

After removal of the orthosis, the main stage of rehabilitation begins, which should include:

• Exercise therapy;
• phonophoresis;
• massage;
• magnetotherapy;
• hydrotherapy and exercises in the pool for unloading the joint;
• UHF;
• electrophoresis;
• paraffin applications;
• diathermy.

All these measures will help to restore the proper level of blood circulation in the place of injury, remove puffiness and pain, which will quickly restore the joint, a long time in an immobilized condition.

A source: http://bolit-koleno.ru/perelom-nadkolennika/

Fracture of the kneecap

An inherent property of the human body: often when a person falls, inertia rests on the knee.

The result of this action is a minor abrasion on the foot, a bruise, and sometimes a severe fracture of the knee joint.

If the trauma has occurred, competent diagnostics, qualified treatment and rehabilitation are important.

The structure of the knee - a complex mix of the musculoskeletal system of the human body. Due to the functionality of the joint, a person is able to move, sit, crouch.

Usually, in a healthy state, the joint bends up to 160 degrees, if the knee is bent to 40 degrees.

The articulation is the largest in the body, withstands daily heavy loads.

A knee fracture is considered to be the most dangerous of injuries, at the same time it is an extremely unprotected and fragile part of the bone system. Tibial, peroneal and femur, patella are the main components of the knee joint.

Menisci - articular cartilage, leveling the surface of the tibia, ligaments and muscles in the joint, maintain the stability of the connection of bones during the running, walking.

The main function of the patella or patella is to protect the femur and tibia from lateral dislocations. It helps muscles and ligaments work effectively, increases strength. Most of the leg injuries are on the knee (60-70%), however, the fracture happens very rarely.

Varieties of knee fractures, their causes

The treatment and rehabilitation of trauma depends on the broken parts of the bones. There are 4 forms of fracture of the knee joint:

• condylar fracture of the thigh;
• fracture of the patella (patella);
• intraarticular fracture of the fibula and condyles;
• tibia and condyles.

The main causes of the fracture are caused, as a rule, by direct impact of a blunt object in the knee or by a sharp contraction of the four-headed muscles of the thigh (occurs when the body turns sharply, and the ligaments of the knee joint do not cope with the powerful load).

Symptomatic of trauma in fracture

For the fracture of the patella, the symptoms are:

1. Local, acute pain immediately after trauma, giving to the knee and thigh. Sometimes the pain is given to the area below the knee.
2. The pain does not stop, it gradually turns into a dull, aching, sensitivity. When palpation, pressing on the condyles there is a sharp pain syndrome.
3. Attempts to lift or move the foot increase pain.
4. Deformity of the patella, its violation: it becomes mobile, it does not fix. There are feelings of hesitation in the knee joint.
5. The knee swells heavily, the swelling gradually increases.
6. Hemarthrosis, the accumulation of blood in the joint cavity. There is a feeling that the knee is "bursting".
7. It is impossible to bend the knee, if the ligaments are not torn, the patient will be able to walk with his leg straightened.

Than the fracture is dangerous

As a result of an accident, a hard object hit, a street injury, a fracture of the kneecap occurs with displacement of bone fragments.

The degree of complexity depends on the characteristics: closed or open.

Unlike the closed fracture, when the integument is not damaged, with an open fracture, muscles, tissues, tendons, ligaments tear, bone is sometimes visible.

Strong changes in the patellar bone or fragments represent a great danger: the fracture is characterized by the displacement of parts of the broken calyx in relation to other bones.

The degree of severity of displacement varies, depending on the strength of the trauma of lateral stretching of the tendon in the extensor. Displacement is usually horizontal - the muscle tendon pulls the patella upward.

Because of muscle contraction, the upper fragment or fragments form a large bruise, eventually descending down to the foot. The fragments disintegrate, forming a cleft.

Fracture with displacement is multi-lobed, treatment is performed by a surgical operation. The consequences of the non-surgical method are irreparable: the risk of improper fusion of the bones is possible.

This leads to disruption of joint mobility in the future, disability. The operation is carried out using bolts and wire.

Rehabilitation of the broken leg part is extremely long, repeated operation to remove bolts and wire is performed only after 2 years.

A severe pain syndrome, an inability to turn or bend the leg, an extensive knee tumor and an internal hematoma are the main signs of a fracture.

Symptoms of a patellar fracture with a displacement are manifested:

• crunch, audible with a fracture, followed by unbearable pain, giving to the knee, just below the knee, into the thigh;
• reduction of the damaged limb (visible even to the naked eye);
• mobility of bone in unnatural directions;
• damage to muscle, even skin tissue, if the fragments are strongly displaced.

Important: fragments of bones should be connected in time, avoiding serious consequences: the knee function will be difficult to restore, the person will not be able to move normally.

Rehabilitation after fracture

First aid measures and methods of treatment

Symptoms become a signal for immediate access to a doctor. If the victim, for example, is in the forest, where there is no possibility to quickly get to the trauma center, and signs of severe trauma are clearly expressed, the patient should be given the first emergency aid. Consists of a number of stages:

1. Remember the importance of the immediate transportation of the victim to the hospital.
2. Do not direct your knee yourself, the action is fraught with severe complications. You can not bend and unbend the knee.
3. If the fracture is open, stop the bleeding by applying a tourniquet. Tie a little above the fracture. Remember or record the exact time of the harnessing. The tourniquet is made from any improvised means, even from a torn shirt.
4. The foot is fixed in a fixed position to avoid additional displacement of the joint or bone fragments. Now it is allowed to transport the patient to the emergency room.

Treatment of knee injury is completely dependent on the type of fracture. Before treatment, you need to make a thorough analysis of the injury by an X-ray examination.

The doctor will exclude the absence of pathologies, then he will prescribe a course of therapy. If necessary, puncture of the joint or MRI is prescribed to clarify the diagnosis.

If the fracture is simple, without bias, treatment is conservative:

• Anesthesia of the injured limb area by local anesthetics.
• Straightening and fixing a damaged limb to real estate.
• Applying gypsum to the leg area to the ankle.

With a severe fracture of the calyx of the knee with a displacement (more than 2 mm), with multiple splinters, it is impossible to eliminate the displacement without surgery, the actions of the doctor:

1. Operative intervention, the doctor restores the joint, folding from the wreckage.
2. Using knitting needles, the patella is fixed. When restoring the joint, bolt-screed and wire are used.
3. Multiple fragments are stitched with a special cord made of dolcane, small fragments are removed.
4. The dressing is applied from gypsum for a period of up to one and a half months.

In the postoperative period, a number of measures will be required:

• in order to avoid edema, keep your foot on a hill;
• reducing the risk of thrombosis and embolism, move fingers and foot;
• when allowed to walk, leaned on the foot with maximum permissive force, avoiding severe pain.

For the result of treatment to be quick and positive, rehabilitation of physical and psychological health is necessary. If necessary, a psychologist works with patients who have suffered serious injuries.

During the treatment, control X-rays are taken to avoid pathologies. Remember, the timing of treatment depends on the degree of complexity of the fracture.

After the removal of gypsum, the rehabilitation of leg trauma in the form of physiotherapy procedures, therapeutic physical training is shown to minimize complications.

Rehabilitation involves removing blood from the joint with a special injection.

Methods of restorative procedures

Restorative measures using exercise therapy, special types of massage contribute to the fact that rehabilitation passes quickly, and the functions of the musculoskeletal system are restored. Regularity of procedures is important.

As a restorative treatment is often used exercises with the ball (squats), sports training equipment (treadmill, exercise bike). Medical exercises should be carried out strictly under the supervision of a physician-physiotherapist.

Accurate performance of the doctor's instructions, timely rehabilitation, adequate nutrition will quickly restore the lost functions of the body and live a full life.

A source: http://OtNogi.ru/travmy/perelom-kolennoj-chashechki.html