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Understanding the Secrets of a Broken Knee: How to Identify the Injury in an X-Ray?
Knee fracture, referred to as patellar fracture, is an important injury to the knee. It is common in sports, accidental falls or direct impacts. Symptoms include knee pain, swelling and bruising, which may make walking difficult or impossible. More seriously, a patella fracture may be accompanied by damage to other bones or ligaments.
Research points out that the patella is often prone to fracture when it is subjected to severe impact or gravity impact; this type of fracture accounts for about 1% of all fractures.
Symptoms and signs
Patellar fractures are often accompanied by a history of trauma. The main symptoms include: knee swelling, significant pain, and even the inability to bend or straighten the knee normally. The pain may be worsened by sitting for long periods of time, especially when standing. In addition, a painful defect may be felt at the injured site, and intra-articular bleeding may occur.
Complications
Complications of a patella fracture may include injury to the tibia, femur, or knee ligaments. In the long term, patients may not be able to regain full range of motion in their knees, and may experience ongoing pain and increased risk of knee osteoarthritis. In the case of an open wound, risks include the possibility of infection and the bone not healing.
Diagnosis
Diagnosis of a knee fracture is based on the patient's symptoms and is usually confirmed using X-rays. In some cases in children, further diagnosis may be made using magnetic resonance imaging (MRI).
Differential diagnosis
Some people may have a normal double-flap patella, which can be mistaken for a fracture. These two-flap bone fragments are usually located on the upper and outer sides of the patella and can be distinguished on imaging studies from X-rays of actual fractures.
Patellar fracture types
Patellar fracture types depend on the manner of injury and include transverse, marginal, osteochondral, and, more rarely, vertical or stellate fractures. These fractures can be further classified as displaced, in which the bone ends are not properly aligned, or nondisplaced, in which the bone ends remain in contact. If the bone fragment of the patella protrudes through the skin and forms an open fracture, it is called an open patellar fracture; otherwise, it is a closed fracture.
Treatment Plan
Depending on the type of fracture, treatment options may include surgical or non-surgical methods. Most non-displaced fractures can be treated with a cast; some displaced fractures can also be treated without surgery, as long as the patient can straighten the leg on his own. The leg is usually held in a straight position for the first three weeks after a fracture, and can be gradually increased in angle as it heals.
Surgical treatment is usually for transverse or comminuted patellar fractures, and postoperative rehabilitation is required to promote recovery.
Rehabilitation and prognosis
Whether you choose surgical or non-surgical treatment, postoperative rehabilitation usually requires the guidance of a physical therapist to gradually increase the weight-bearing exercises, improve the range of motion of the knee joint, and reduce stiffness. The prognosis after treatment is generally good, but may be poorer if there is damage to the articular surface or quadriceps mechanism.
Epidemiology of fractures
According to statistics, patellar fractures account for about 1% of all fractures. Men are more likely to be injured than women, and middle-aged people are the main affected ones. With the aging population and the increase in hip replacement surgeries, the number of patellar fracture cases is also increasing year by year.
Historical evolution
Before the 19th century, patellar fractures were usually treated without surgery and only with fixation. However, this treatment often resulted in failure of the fracture fragments to heal well, resulting in long-term pain and disability. As the understanding of the role of the patella has increased, more surgical techniques have emerged to address patient pain and dissatisfaction.
The understanding and treatment of these patellar fractures have evolved over time. Do you have a deeper understanding of this?
