Causes and risk factors
Fracture of patella is caused due to injury like a fall or blow. Strong force trauma, especially seen in road accidents or due to fall from height, are important causes of fracture. People engaged in athletics are also more prone towards such injuries. Violent and strong contraction of the thigh muscles can also pull the patella leading to its dislocation.
Clinical presentation:
The injury either can cause a simple crack on the patellar bone or can lead to the bone shatterring into pieces. Depending upon the extent of the injury, the patellar fracture is classified into different types – open fracture (this is seen in severe road accidents where the skin is completely peeled off or broken and the bone is exposed), comminuted fractures (the bone is broken into 2-3 pieces), displaced fracture (the broken bone is displaced from its original position), stable fracture (the bone is broken but is retained in its position).
Unlike any other fracture, pain is the predominant feature which is aggravated by movement; hence, restricted movement is seen. The patient is unable to straighten the leg, difficulty in walking can occur. Swelling is seen in and around the knee region. The affected leg seems to be deformed. On examination, tenderness is localized to the patellar region in case of an undisplaced fracture. In case where the bone is broken into pieces, creptitus is felt. Patellar fracture often leads to certain complications like stiffness of the knee, weakness of extensors, and even osteoarthritis.
Investigations:
Diagnosis is done on the basis of the symptoms narrated by the patient and the physical examination carried out by the orthopedic doctor. Investigations which are done are x-ray of the bone. Usually routine x-rays or specialized digital x-rays along with CT scan and MRI are advised.
Treatment:
Rest and restriction of movement needs to adopted. Analgesic or nonsteroidal anti-inflammatory drugs are advised by the orthopedic doctor. In cases where the broken bone is retained to its position, the treatment plan consists of use of casts and splints which help in union of the cracked bone. It is retained for 6-8 weeks. In case of comminuted and displaced fracture, surgical intervention is needed. Further physiotherapy exercises are advised to strengthen the muscles and improve the mobility.
Other Modes of treatment:
Certain other modes of treatment can also be helpful in coping up with the symptom. Taking into consideration the symptoms in a holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints. Certain yoga exercises can also be helpful in strengthening the muscles.
