Knee
Fractures
- Patella Fracture
- Tibial Plateau Fracture
- Distal Femur Fracture
- Tibial Eminence Fracture
- Intercondylar Eminence Fracture
Description
The patella is a bone that “floats” on top of the knee. It serves at a fixation point for the tendons that are responsible for extending the knee and is crucial to a person’s ability to place weight on the legs. A patella fracture occurs when a direct force is transmitted to the bone, causing it to break.
What are the causes?
Patella fractures occur as a result of trauma, particularly falls, motor vehicle accidents, a direct blow to the knee or jumping from a height.
What are the symptoms?
Patella fractures cause immediate pain, swelling, and inability to bear weight on the leg. If the fracture is badly displaced, a deformity may be present.
How is it diagnosed?
Your surgeon will perform a physical exam and obtain X-rays. The knee will be swollen and painful on exam. Swelling is present in the joint. X-rays will confirm the diagnosis. Your surgeon may order an MRI or CT scan if an operation is indicated.
How is it treated?
Non-operative
For patella fractures that are not displaced, the knee is immobilized until the fracture heals. A splint, cast, or brace can be used to immobilize the knee, depending on the type of fracture. Physical therapy is started at your surgeon’s discretion.
Operative
For patella fractures that are displaced, surgery is usually recommended. Screws are placed in the bone to repair the fracture. Suture may be used to wrap through and around the screws to hold the fracture pieces close together. Physical therapy is begun postoperatively at your surgeon’s discretion.
Description
A tibial plateau fracture is a break in the leg bone that occurs just below the knee joint. An intra-articular fracture extends into the knee joint. An extra-articular fracture does not enter the joint.
What are the causes?
Tibial plateau fractures occur as a result of trauma, particularly falls or motor vehicle accidents, or with a direct blow to the knee.
What are the symptoms?
Tibial plateau fractures cause pain, swelling, and inability to bear weight on the leg. If the fracture is badly displaced, a deformity may be present.
How is it diagnosed?
Your surgeon will perform a physical exam and obtain X-rays. The knee will be swollen and painful on exam. Swelling is present in the joint. X-rays will confirm the diagnosis. Your surgeon may order an MRI or CT scan if an operation is indicated.
How is it treated?
Non-operative
For tibial plateau fractures that are not displaced, the knee is immobilized until the fracture heals. A splint, cast, or brace can be used to immobilize the knee, depending on the type of fracture. Physical therapy is started at your surgeon’s discretion.
Operative
For tibial plateau fractures that enter the joint or are displaced, surgery is usually recommended. A plate and screws placed in the bone may be used to repair the fracture. Physical therapy is begun postoperatively at your surgeon’s discretion. In cases where arthritis is present in the joint, a displaced fracture may be allowed to heal without surgery, and a total knee planned if the patient remains symptomatic after the fracture has healed.
Description
A distal femur fracture is a break in the thighbone that occurs just above the knee joint. An intra-articular fracture extends into the knee joint. An extra-articular fracture does not enter the joint.
What are the causes?
Distal femur fractures occur as a result of trauma, particularly falls or motor vehicle accidents.
What are the symptoms?
Distal femur fractures cause pain, swelling, and inability to bear weight on the leg. If the fracture is badly displaced, a deformity may be present.
How is it diagnosed?
Your surgeon will perform a physical exam and obtain X-rays. The knee will be swollen and painful on exam. Swelling is present in the joint. X-rays will confirm the diagnosis. Your surgeon may order an MRI or CT scan if an operation is indicated.
How is it treated?
Non-operative
For distal femur fractures that are not displaced, the knee is immobilized until the fracture heals. A splint, cast, or brace can be used to immobilize the knee, depending on the type of fracture. Physical therapy is started at your surgeon’s discretion.
Operative
For distal femur fractures that enter the joint or are displaced, surgery is usually recommended. A plate and screws or a rod placed in the bone may be used to repair the fracture. Physical therapy is begun postoperatively at your surgeon’s discretion.
Description
The tibial eminence is the bony projection in the center of the knee where the anterior cruciate ligament attaches on the shin bone (tibia). A tibial eminence fracture occurs when the anterior cruciate ligament (ACL) pulls off of its attachment, taking a piece of bone with it.
What are the causes?
Tibial eminence fractures occur with similar mechanisms of injury as ACL tears. They may result of trauma, particularly falls, or hyperextension injuries to the knee.
What are the symptoms?
Tibial eminence fractures cause pain, swelling, and inability to bear weight on the leg. The knee may also feel unstable or like it will “give way” if weight is put onto the leg.
How is it diagnosed?
Your surgeon will perform a physical exam and obtain X-rays. The knee will be swollen and painful on exam. Swelling is present in the joint. Your surgeon will evaluate the range of motion and stability of the ligaments, which may feel “loose” because the ACL is no longer attached to the bone. X-rays may confirm the diagnosis. Your surgeon may order an MRI to confirm the diagnosis.
How is it treated?
Non-operative
For tibial eminence fractures that are not displaced, the knee is immobilized in extension until the fracture heals. A splint, cast, or brace can be used to immobilize the knee. Physical therapy will be started at your surgeon’s discretion.
Operative
For tibial eminence fractures that are displaced, minimally-invasive arthroscopic surgery is usually recommended. The tibial eminence fracture is fixed to its origin with suture, screws or an anchor.
Description
The intercondylar eminence is the bony projection in the center of the knee where the anterior cruciate ligament attaches. An intercondylar eminence fracture occurs when the anterior cruciate ligament (ACL) pulls off of its tibial attachment, taking a piece of bone with it.
What are the causes?
Intercondylar eminence fractures occur as a result of trauma, particularly falls from a bicycle or hyperextension injuries to the knee resulting from direct blows.
What are the symptoms?
Patients complain of pain, swelling, and inability to bear weight or straighten the leg.
How is it diagnosed?
The knee will be swollen and painful on exam. Swelling is present in the joint. The ACL will appear lax on exam. X-rays will confirm the diagnosis. Your surgeon may order an MRI or CT scan if an operation is indicated.
How is it treated?
Non-operative
For fractures that are not displaced, the knee is immobilized in extension until the fracture heals. A splint, cast, or brace can be used to immobilize the knee, depending on the type of fracture and how stable it is. Physical therapy should be started as soon as the fracture will allow to prevent stiffness in the knee.
Operative
For fractures that are displaced, arthroscopic surgery is usually recommended. The tibial eminence is sewn back, screwed, or tacked down to the leg bone. The hole in the bone where the fragment is detached is deepened, and the avulsed fragment is recessed in this hole to compensate for stretching of the ACL that occurred at the time of injury.
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